Provider Demographics
NPI:1225872211
Name:SAVING GRACE SENIOR CARE LLC
Entity type:Organization
Organization Name:SAVING GRACE SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DONAE
Authorized Official - Middle Name:
Authorized Official - Last Name:DYSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-358-5400
Mailing Address - Street 1:6919 E 10TH ST STE E3A
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4819
Mailing Address - Country:US
Mailing Address - Phone:317-358-5400
Mailing Address - Fax:
Practice Address - Street 1:6919 E 10TH ST STE E3A
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4819
Practice Address - Country:US
Practice Address - Phone:317-358-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-24
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service