Provider Demographics
NPI:1043524127
Name:GRACE HEALTHCARE SOLUTIONS, INC.
Entity Type:Organization
Organization Name:GRACE HEALTHCARE SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:HURBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-993-6004
Mailing Address - Street 1:217 W AVENUE A
Mailing Address - Street 2:
Mailing Address - City:BELLE GLADE
Mailing Address - State:FL
Mailing Address - Zip Code:33430-3019
Mailing Address - Country:US
Mailing Address - Phone:561-993-6004
Mailing Address - Fax:561-993-1111
Practice Address - Street 1:7368 STATE ROAD 15, US 441
Practice Address - Street 2:
Practice Address - City:PAHOKEE
Practice Address - State:FL
Practice Address - Zip Code:33476
Practice Address - Country:US
Practice Address - Phone:561-993-6004
Practice Address - Fax:561-993-1111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-02
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL=========OtherFEDERAL EMPLOYER IDENTIFICATION NUMBER