Provider Demographics
NPI:1386439305
Name:GRACE-EDEN HOMECARE SERVICES
Entity type:Organization
Organization Name:GRACE-EDEN HOMECARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:MENDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:585-694-1004
Mailing Address - Street 1:6101 MELODY LN APT 2002
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-9302
Mailing Address - Country:US
Mailing Address - Phone:585-694-1004
Mailing Address - Fax:
Practice Address - Street 1:6101 MELODY LN APT 2002
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-9302
Practice Address - Country:US
Practice Address - Phone:585-694-1004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-10
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care