Provider Demographics
NPI:1033960869
Name:GRACE MOUNTAIN HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:GRACE MOUNTAIN HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:OWUSU
Authorized Official - Last Name:AFRIYIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-833-0332
Mailing Address - Street 1:345 KNOLLRIDGE CT APT 202
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-6591
Mailing Address - Country:US
Mailing Address - Phone:513-833-0332
Mailing Address - Fax:
Practice Address - Street 1:345 KNOLLRIDGE CT APT 202
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-6591
Practice Address - Country:US
Practice Address - Phone:513-833-0332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health