Provider Demographics
NPI:1417644899
Name:GRACIELA PEACE
Entity Type:Organization
Organization Name:GRACIELA PEACE
Other - Org Name:GRACE CARE PHYSICAL THERAPY AND HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GRACIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:PEACE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT, PT
Authorized Official - Phone:661-240-3927
Mailing Address - Street 1:790 S GRADE RD
Mailing Address - Street 2:
Mailing Address - City:ALPINE
Mailing Address - State:CA
Mailing Address - Zip Code:91901-2912
Mailing Address - Country:US
Mailing Address - Phone:661-240-3927
Mailing Address - Fax:619-243-8736
Practice Address - Street 1:790 S GRADE RD
Practice Address - Street 2:
Practice Address - City:ALPINE
Practice Address - State:CA
Practice Address - Zip Code:91901-2912
Practice Address - Country:US
Practice Address - Phone:661-240-3927
Practice Address - Fax:619-243-8736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty