Provider Demographics
NPI:1104623404
Name:GRACE HILLS
Entity type:Organization
Organization Name:GRACE HILLS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COE/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:THULARE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-373-6343
Mailing Address - Street 1:130 LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:LEOMINSTER
Mailing Address - State:MA
Mailing Address - Zip Code:01453-1770
Mailing Address - Country:US
Mailing Address - Phone:508-373-6343
Mailing Address - Fax:
Practice Address - Street 1:130 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:LEOMINSTER
Practice Address - State:MA
Practice Address - Zip Code:01453-1770
Practice Address - Country:US
Practice Address - Phone:508-373-6343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care