Provider Demographics
NPI:1962275800
Name:GRACE HEALTH HOME CARE LLC
Entity type:Organization
Organization Name:GRACE HEALTH HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:DIEUDONNE
Authorized Official - Middle Name:H
Authorized Official - Last Name:RUTURWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-344-6916
Mailing Address - Street 1:5201 HEATHER WAY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-8707
Mailing Address - Country:US
Mailing Address - Phone:937-344-6916
Mailing Address - Fax:
Practice Address - Street 1:5201 HEATHER WAY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45424-8707
Practice Address - Country:US
Practice Address - Phone:937-344-6916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services