Provider Demographics
NPI:1063513620
Name:GRACE HOME HEALTH INC
Entity type:Organization
Organization Name:GRACE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ZACHARIAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-326-1700
Mailing Address - Street 1:5045 LORIMAR DR
Mailing Address - Street 2:SUITE 260
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5720
Mailing Address - Country:US
Mailing Address - Phone:469-326-1700
Mailing Address - Fax:469-326-1704
Practice Address - Street 1:5045 LORIMAR DR
Practice Address - Street 2:SUITE 260
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5720
Practice Address - Country:US
Practice Address - Phone:469-326-1700
Practice Address - Fax:469-326-1704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008284251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX679309Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER