Provider Demographics
NPI:1417280934
Name:GRACIA HOSPICE CARE, LLC
Entity Type:Organization
Organization Name:GRACIA HOSPICE CARE, LLC
Other - Org Name:GRACIA HOSPICE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER/ADMINISTRATOR/ADON
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:N
Authorized Official - Last Name:RICHARDS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:956-661-1177
Mailing Address - Street 1:717 E ESPERANZA AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-1402
Mailing Address - Country:US
Mailing Address - Phone:956-661-1177
Mailing Address - Fax:956-661-1178
Practice Address - Street 1:717 E ESPERANZA AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-1402
Practice Address - Country:US
Practice Address - Phone:956-661-1177
Practice Address - Fax:956-661-1178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-16
Last Update Date:2014-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251G00000X
TX013000251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based