Provider Demographics
NPI:1326426685
Name:GRACE HEALTH, INC.
Entity Type:Organization
Organization Name:GRACE HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:S
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-965-8866
Mailing Address - Street 1:181 EMMETT ST W
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49037-2963
Mailing Address - Country:US
Mailing Address - Phone:269-966-2600
Mailing Address - Fax:269-965-4773
Practice Address - Street 1:181 EMMETT ST W
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49037-2963
Practice Address - Country:US
Practice Address - Phone:269-966-2600
Practice Address - Fax:269-965-4773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-07
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI700A360900OtherBLUE CROSS BLUE SHIELD
231836OtherMEDICARE LOCATION NUMBER
0A36090OtherMEDICARE GROUP NUMBER