MEDICARE: ALL BY GRACE HOME HEALTH CARE, 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	251E00000X	Home Health Agency	010939	TX

General Provider Information

NPI Number	:	1295885077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL BY GRACE HOME HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	1402 CORINTH ST
Second Line	:	SUITE 113
City	:	DALLAS
State	:	TX
Zip	:	75215-2111
Country	:	US
Telephone Number	:	214-550-0215
Fax Number	:	214-550-0885

Provider Business Practice Location Address
First Line	:	1402 CORINTH ST
Second Line	:	SUITE 113
City	:	DALLAS
State	:	TX
Zip	:	75215-2111
Country	:	US
Telephone Number	:	214-550-0215
Fax Number	:	214-550-0885

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. JENNIFER OLABISI SAMUELS
Credential	:	RN
Telephone Number	:	214-550-0215

Provider Enumeration Date	:	01/12/2007
Last Update Date	:	05/05/2009

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