Provider Demographics
NPI:1710670047
Name:GRACE TOTAL HOMECARE SERVICES LLC.
Entity Type:Organization
Organization Name:GRACE TOTAL HOMECARE SERVICES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAYFRED
Authorized Official - Middle Name:JOSEPHINE
Authorized Official - Last Name:ANSAH
Authorized Official - Suffix:
Authorized Official - Credentials:CEO/RN
Authorized Official - Phone:201-779-9632
Mailing Address - Street 1:11 STATE ST UNIT 202
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-5429
Mailing Address - Country:US
Mailing Address - Phone:201-402-9550
Mailing Address - Fax:201-407-9549
Practice Address - Street 1:11 STATE ST UNIT 202
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-5429
Practice Address - Country:US
Practice Address - Phone:201-402-9550
Practice Address - Fax:201-402-9549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health