Provider Demographics
NPI:1174278949
Name:GRACE HOME HEALTH CARE OF HOUSTON
Entity Type:Organization
Organization Name:GRACE HOME HEALTH CARE OF HOUSTON
Other - Org Name:GRACE HOME HEALTH CARE OF HOUSTON
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR1
Authorized Official - Prefix:MR
Authorized Official - First Name:SARAFA
Authorized Official - Middle Name:OLATAYO
Authorized Official - Last Name:BABALOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-868-0572
Mailing Address - Street 1:5238 JAY THRUSH DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-4006
Mailing Address - Country:US
Mailing Address - Phone:832-868-0572
Mailing Address - Fax:
Practice Address - Street 1:5238 JAY THRUSH DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77407-4006
Practice Address - Country:US
Practice Address - Phone:832-868-0572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-19
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child