Provider Demographics
NPI:1104408434
Name:GRACE HOLISTIC SUPPORT HOME HEALTHCARE LLC
Entity type:Organization
Organization Name:GRACE HOLISTIC SUPPORT HOME HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EUGENIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:267-588-8699
Mailing Address - Street 1:137 N BISHOP AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON HEIGHTS
Mailing Address - State:PA
Mailing Address - Zip Code:19018-1305
Mailing Address - Country:US
Mailing Address - Phone:484-466-6045
Mailing Address - Fax:
Practice Address - Street 1:137 N BISHOP AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON HEIGHTS
Practice Address - State:PA
Practice Address - Zip Code:19018-1305
Practice Address - Country:US
Practice Address - Phone:484-466-6045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care