Provider Demographics
NPI:1467088765
Name:WITHGRACE CARE SERVICES LLC
Entity Type:Organization
Organization Name:WITHGRACE CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:TWESIGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-349-2723
Mailing Address - Street 1:3613 FRAZIER CT
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76040-6601
Mailing Address - Country:US
Mailing Address - Phone:817-349-2723
Mailing Address - Fax:817-518-9463
Practice Address - Street 1:3613 FRAZIER CT
Practice Address - Street 2:
Practice Address - City:EULESS
Practice Address - State:TX
Practice Address - Zip Code:76040-6601
Practice Address - Country:US
Practice Address - Phone:817-349-2723
Practice Address - Fax:817-518-9463
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health