Provider Demographics
NPI:1508346578
Name:GRACE RACE PALLIATIVE HOSPICE LLC.
Entity type:Organization
Organization Name:GRACE RACE PALLIATIVE HOSPICE LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAVITT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:463-796-8150
Mailing Address - Street 1:13207 WATER OAK PARK CIR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4035
Mailing Address - Country:US
Mailing Address - Phone:346-796-8150
Mailing Address - Fax:346-260-5958
Practice Address - Street 1:13207 WATER OAK PARK CIR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4035
Practice Address - Country:US
Practice Address - Phone:346-796-8150
Practice Address - Fax:346-260-5958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-18
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based