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NPI Code Detail

MEDICARE: GRACE HOUSE

MEDICARE: GRACE HOUSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1372500000XChore Provider
2372600000XAdult Companion
3374U00000XHome Health Aide
4376J00000XHomemaker
5251E00000XHome Health Agency

General Provider Information

NPI Number : 1144031626
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE HOUSE
Provider Business Mailing Address
First Line : 1730 LEWIS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-5233
Country : US
Telephone Number : 424-299-0643
Fax Number :
Provider Business Practice Location Address
First Line : 1730 LEWIS AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89101-5233
Country : US
Telephone Number : 424-299-0643
Fax Number :
Authorized Official
Title or Position : BOARD MEMBER
Name : RAY JUNG
Credential :
Telephone Number : 424-299-0643
Provider Enumeration Date : 01/15/2025
Last Update Date : 01/15/2025

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Directions to “GRACE HOUSE ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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