Provider Demographics
NPI:1023842630
Name:GRACE ELDERLY CARE HOME LLC
Entity type:Organization
Organization Name:GRACE ELDERLY CARE HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:
Authorized Official - Last Name:DE BOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-696-2455
Mailing Address - Street 1:25503 OAKHURST DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-5049
Mailing Address - Country:US
Mailing Address - Phone:832-696-2455
Mailing Address - Fax:
Practice Address - Street 1:25615 SPRING RIDGE DR
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77386-1517
Practice Address - Country:US
Practice Address - Phone:832-696-2455
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility