Provider Demographics
NPI:1467062752
Name:GRACE COMPANION CARE
Entity Type:Organization
Organization Name:GRACE COMPANION CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:PETIT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-991-9983
Mailing Address - Street 1:805 SHERIDAN ST
Mailing Address - Street 2:
Mailing Address - City:HOLDREGE
Mailing Address - State:NE
Mailing Address - Zip Code:68949-3259
Mailing Address - Country:US
Mailing Address - Phone:308-991-9983
Mailing Address - Fax:
Practice Address - Street 1:805 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLDREGE
Practice Address - State:NE
Practice Address - Zip Code:68949-3259
Practice Address - Country:US
Practice Address - Phone:308-991-9983
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-03
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care