Provider Demographics
NPI:1073904009
Name:GRACE HOME HEALTHCARE, LLC
Entity type:Organization
Organization Name:GRACE HOME HEALTHCARE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:AUMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-486-5330
Mailing Address - Street 1:10 CROSSROADS DRIVE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:410-486-5330
Mailing Address - Fax:
Practice Address - Street 1:9735 MAIN STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-3736
Practice Address - Country:US
Practice Address - Phone:703-865-7370
Practice Address - Fax:703-865-5520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-12
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health