Provider Demographics
NPI:1972395374
Name:OPTIGRACE HEALTH SERVICES
Entity type:Organization
Organization Name:OPTIGRACE HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MBAZURIKE
Authorized Official - Middle Name:P
Authorized Official - Last Name:EZE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-250-0078
Mailing Address - Street 1:13001 CLARKSBURG SQUARE RD
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-4399
Mailing Address - Country:US
Mailing Address - Phone:281-250-0078
Mailing Address - Fax:
Practice Address - Street 1:13001 CLARKSBURG SQUARE RD
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-4399
Practice Address - Country:US
Practice Address - Phone:281-250-0078
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-21
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care