MEDICARE: PARTNERS IN GRACE

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	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1942508601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARTNERS IN GRACE

Provider Business Mailing Address
First Line	:	2222 DEER MEADOW DR
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-7152
Country	:	US
Telephone Number	:	972-495-6000
Fax Number	:	972-692-5164

Provider Business Practice Location Address
First Line	:	3241 DANIELDALE RD
Second Line	:
City	:	LANCASTER
State	:	TX
Zip	:	75134-1519
Country	:	US
Telephone Number	:	972-228-0960
Fax Number	:	972-692-5164

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	ELLA BORODYANSKY
Credential	:
Telephone Number	:	972-495-6000

Provider Enumeration Date	:	03/04/2011
Last Update Date	:	03/04/2011

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Directions to “PARTNERS IN GRACE ” Practice Location

Language	Start Address	Practice Location

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