Provider Demographics
NPI:1245620202
Name:LOVING GRACE HOME HEALTH INC
Entity Type:Organization
Organization Name:LOVING GRACE HOME HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-852-0097
Mailing Address - Street 1:107 E BENTON ST
Mailing Address - Street 2:
Mailing Address - City:MORRIS
Mailing Address - State:IL
Mailing Address - Zip Code:60450-1805
Mailing Address - Country:US
Mailing Address - Phone:773-852-0097
Mailing Address - Fax:
Practice Address - Street 1:182 WEDGEPORT CIR
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-3756
Practice Address - Country:US
Practice Address - Phone:773-852-0097
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health