Provider Demographics
NPI:1164003901
Name:GRACE CARE INC
Entity Type:Organization
Organization Name:GRACE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:E
Authorized Official - Last Name:OSBORN
Authorized Official - Suffix:
Authorized Official - Credentials:HCA
Authorized Official - Phone:580-237-6911
Mailing Address - Street 1:1909 W OWEN K GARRIOTT RD
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-5528
Mailing Address - Country:US
Mailing Address - Phone:580-237-6911
Mailing Address - Fax:888-235-9348
Practice Address - Street 1:1909 W OWEN K GARRIOTT RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-5528
Practice Address - Country:US
Practice Address - Phone:580-237-6911
Practice Address - Fax:888-235-9348
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care