MEDICARE: GRACE HOME HOSPICE INC.

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	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1275340002
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE HOME HOSPICE INC.

Provider Business Mailing Address
First Line	:	1623 CENTRAL AVE STE 216
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-4531
Country	:	US
Telephone Number	:	307-201-2022
Fax Number	:

Provider Business Practice Location Address
First Line	:	1623 CENTRAL AVE STE 216
Second Line	:
City	:	CHEYENNE
State	:	WY
Zip	:	82001-4531
Country	:	US
Telephone Number	:	307-201-2022
Fax Number	:

Authorized Official
Title or Position	:	CEO/FOUNDER
Name	:	SHERRYL ESHELMAN
Credential	:
Telephone Number	:	704-214-3175

Provider Enumeration Date	:	12/16/2024
Last Update Date	:	07/21/2025

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