Provider Demographics
NPI:1598368763
Name:GIFTS OF GRACE LLC
Entity Type:Organization
Organization Name:GIFTS OF GRACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:513-227-6376
Mailing Address - Street 1:2692 MADISON RD STE N1-168
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45208-1321
Mailing Address - Country:US
Mailing Address - Phone:513-227-6376
Mailing Address - Fax:513-832-8149
Practice Address - Street 1:2692 MADISON RD STE N1-168
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-1321
Practice Address - Country:US
Practice Address - Phone:513-227-6376
Practice Address - Fax:513-832-8149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No347C00000XTransportation ServicesPrivate Vehicle