Provider Demographics
NPI:1285301861
Name:WITH MUCH GRACE INC
Entity type:Organization
Organization Name:WITH MUCH GRACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-901-8806
Mailing Address - Street 1:9059 SPRINGBORO PIKE STE C
Mailing Address - Street 2:
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-4418
Mailing Address - Country:US
Mailing Address - Phone:937-901-8806
Mailing Address - Fax:
Practice Address - Street 1:9059 SPRINGBORO PIKE STE C
Practice Address - Street 2:
Practice Address - City:MIAMISBURG
Practice Address - State:OH
Practice Address - Zip Code:45342-4418
Practice Address - Country:US
Practice Address - Phone:937-901-8806
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5718782Medicaid