Provider Demographics
NPI:1477924546
Name:SMITH HOMES OF GRACE INC.
Entity Type:Organization
Organization Name:SMITH HOMES OF GRACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:PERRITHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-552-4819
Mailing Address - Street 1:1024 MEADOWBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-3262
Mailing Address - Country:US
Mailing Address - Phone:214-552-4819
Mailing Address - Fax:972-629-8600
Practice Address - Street 1:1024 MEADOWBROOKE DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-3262
Practice Address - Country:US
Practice Address - Phone:214-552-4819
Practice Address - Fax:972-629-8600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-14
Last Update Date:2015-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care