Provider Demographics
NPI:1497897789
Name:GRACE RABI VENTURES LLC
Entity Type:Organization
Organization Name:GRACE RABI VENTURES LLC
Other - Org Name:HOME TO YOU
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EGHAREVBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:963-893-7093
Mailing Address - Street 1:243 INDEPENDENCE SPGS
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-3335
Mailing Address - Country:US
Mailing Address - Phone:903-893-7093
Mailing Address - Fax:903-893-2805
Practice Address - Street 1:243 INDEPENDENCE SPGS
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75090-3335
Practice Address - Country:US
Practice Address - Phone:903-893-7093
Practice Address - Fax:903-893-2805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00000000310400000X
TX310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility