Provider Demographics
NPI:1821255415
Name:GRACE RX STAFFING AND HOME HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:GRACE RX STAFFING AND HOME HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR SUPERVISING NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:O
Authorized Official - Last Name:MADUKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-483-6443
Mailing Address - Street 1:3917 W SUBLETT RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-4691
Mailing Address - Country:US
Mailing Address - Phone:817-483-6443
Mailing Address - Fax:
Practice Address - Street 1:3917 W SUBLETT RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-4691
Practice Address - Country:US
Practice Address - Phone:817-483-6443
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX800966318251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health