Provider Demographics
NPI:1689118861
Name:AGING WITH GRACE IHS, LLC
Entity Type:Organization
Organization Name:AGING WITH GRACE IHS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM/MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:HENSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:314-402-1932
Mailing Address - Street 1:3675 WEST OUTER ROAD
Mailing Address - Street 2:SUITE 203 A
Mailing Address - City:ARNOLD
Mailing Address - State:MO
Mailing Address - Zip Code:63010-5201
Mailing Address - Country:US
Mailing Address - Phone:314-270-9229
Mailing Address - Fax:314-552-7047
Practice Address - Street 1:3675 WEST OUTER ROAD
Practice Address - Street 2:SUITE 203 A
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-5201
Practice Address - Country:US
Practice Address - Phone:314-270-9229
Practice Address - Fax:314-552-7047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care