Provider Demographics
NPI:1457026486
Name:BY THE GRACE HOME HEALTH CARE
Entity Type:Organization
Organization Name:BY THE GRACE HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAREGIVER
Authorized Official - Prefix:
Authorized Official - First Name:LYSETT
Authorized Official - Middle Name:B
Authorized Official - Last Name:ORTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:682-553-9777
Mailing Address - Street 1:904 WALTER ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-7028
Mailing Address - Country:US
Mailing Address - Phone:683-553-9777
Mailing Address - Fax:
Practice Address - Street 1:904
Practice Address - Street 2:WALTER ST
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022
Practice Address - Country:US
Practice Address - Phone:682-553-9777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-11
Last Update Date:2021-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty