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NPI Code Detail

MEDICARE: GRACE HOME HEALTH CARE

MEDICARE: GRACE HOME HEALTH CARE
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
1251E00000XHome Health AgencyCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2ZZZ03422ZOTHERCABLUESHIELD OF CA

General Provider Information

NPI Number : 1326032137
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE HOME HEALTH CARE
Provider Business Mailing Address
First Line : 1739 TERMINO AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2121
Country : US
Telephone Number : 562-498-0203
Fax Number : 562-498-0223
Provider Business Practice Location Address
First Line : 1739 TERMINO AVE
Second Line :
City : LONG BEACH
State : CA
Zip : 90804-2121
Country : US
Telephone Number : 562-498-0203
Fax Number : 562-498-0223
Authorized Official
Title or Position : CEO/PRESIDENT
Name : MR. ANGELITO D CADIENTE
Credential : OWNER
Telephone Number : 562-498-0203
Provider Enumeration Date : 09/07/2005
Last Update Date : 03/26/2008

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Directions to “GRACE HOME HEALTH CARE ” Practice Location

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