Provider Demographics
NPI:1245100460
Name:GRACE HOMES HEALTH SERVICES LLC
Entity type:Organization
Organization Name:GRACE HOMES HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUDE
Authorized Official - Middle Name:BUSONG
Authorized Official - Last Name:FONGUH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:513-602-2289
Mailing Address - Street 1:PO BOX 441
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-0441
Mailing Address - Country:US
Mailing Address - Phone:513-602-2289
Mailing Address - Fax:
Practice Address - Street 1:5660 SOUTHWYCK BLVD # 220A
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-1566
Practice Address - Country:US
Practice Address - Phone:513-602-2289
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-11
Last Update Date:2025-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No385H00000XRespite Care FacilityRespite Care