Provider Demographics
NPI:1073058590
Name:GRACE HOME CARE
Entity Type:Organization
Organization Name:GRACE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTIVE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLAMY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-625-7434
Mailing Address - Street 1:616 FOXTAIL DR
Mailing Address - Street 2:
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63034-2035
Mailing Address - Country:US
Mailing Address - Phone:314-830-2420
Mailing Address - Fax:314-830-2420
Practice Address - Street 1:616 FOXTAIL DR
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63034-2035
Practice Address - Country:US
Practice Address - Phone:314-830-2420
Practice Address - Fax:314-830-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-20
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health