MEDICARE: GRACE NURSING CONSULTING, LLC.

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
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1235975251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE NURSING CONSULTING, LLC.

Provider Business Mailing Address
First Line	:	3428 DODGE PARK RD
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-2053
Country	:	US
Telephone Number	:	202-910-9056
Fax Number	:

Provider Business Practice Location Address
First Line	:	3428 DODGE PARK RD
Second Line	:
City	:	LANDOVER
State	:	MD
Zip	:	20785-2053
Country	:	US
Telephone Number	:	202-910-9056
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	VALERY NDONKU
Credential	:	MD
Telephone Number	:	202-910-9056

Provider Enumeration Date	:	07/09/2024
Last Update Date	:	07/09/2024

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