MEDICARE: GRACE HEALTH & WELLNESS COMPANY 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	364SA2200X	Adult Health Clinical Nurse Specialist
2	364SG0600X	Gerontology Clinical Nurse Specialist

General Provider Information

NPI Number	:	1598573438
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE HEALTH & WELLNESS COMPANY LLC

Provider Business Mailing Address
First Line	:	1601 MAIN ST STE 404
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-3244
Country	:	US
Telephone Number	:	346-444-3653
Fax Number	:	855-576-4465

Provider Business Practice Location Address
First Line	:	1601 MAIN ST STE 404
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77469-3244
Country	:	US
Telephone Number	:	512-663-4661
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ABIGAIL LANEY
Credential	:	RN, AGCNS-BC
Telephone Number	:	512-663-4661

Provider Enumeration Date	:	12/23/2024
Last Update Date	:	01/16/2026

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Directions to “GRACE HEALTH & WELLNESS COMPANY LLC ” Practice Location

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