Provider Demographics
NPI:1215216742
Name:HIS GRACE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:HIS GRACE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:
Authorized Official - Last Name:GALINSUGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-443-7023
Mailing Address - Street 1:1201 N WATSON RD STE 261
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-6258
Mailing Address - Country:US
Mailing Address - Phone:817-726-3097
Mailing Address - Fax:682-206-0797
Practice Address - Street 1:9013 FRIENDSWOOD DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76123-2723
Practice Address - Country:US
Practice Address - Phone:817-443-7023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health