Provider Demographics
NPI:1083489488
Name:GRACE HEALTHCARE SERVICES
Entity Type:Organization
Organization Name:GRACE HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:ROSEJUNE
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:ONUMAJURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-240-7715
Mailing Address - Street 1:60 HOLLIS ST
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-4971
Mailing Address - Country:US
Mailing Address - Phone:617-240-7715
Mailing Address - Fax:
Practice Address - Street 1:60 HOLLIS ST
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:MA
Practice Address - Zip Code:02368-4971
Practice Address - Country:US
Practice Address - Phone:617-240-7715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care