Provider Demographics
NPI:1588189906
Name:GRACE PARTAKERS HOMECARE LLC
Entity Type:Organization
Organization Name:GRACE PARTAKERS HOMECARE LLC
Other - Org Name:HOMESLICE CAREGIVERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DOLAPO
Authorized Official - Middle Name:TIWALADE
Authorized Official - Last Name:ADEKOYA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:512-992-5210
Mailing Address - Street 1:3327 HIDALGO LOOP
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-2158
Mailing Address - Country:US
Mailing Address - Phone:512-992-5210
Mailing Address - Fax:512-201-4390
Practice Address - Street 1:3327 HIDALGO LOOP
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-2158
Practice Address - Country:US
Practice Address - Phone:512-992-5210
Practice Address - Fax:512-201-4390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty