Provider Demographics
NPI:1881558138
Name:GRATIAS, INC.
Entity type:Organization
Organization Name:GRATIAS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:HERR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-444-9825
Mailing Address - Street 1:63 VIA PICO PLZ # 221
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-3998
Mailing Address - Country:US
Mailing Address - Phone:910-444-9825
Mailing Address - Fax:910-444-9825
Practice Address - Street 1:114 E AVENIDA SAN GABRIEL
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672
Practice Address - Country:US
Practice Address - Phone:910-444-9825
Practice Address - Fax:910-444-9825
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-11
Last Update Date:2025-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies