Provider Demographics
NPI:1861844870
Name:GRACE ON GRACE
Entity Type:Organization
Organization Name:GRACE ON GRACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:EURONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:256-794-7387
Mailing Address - Street 1:1308 SPRINGHILL RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-4457
Mailing Address - Country:US
Mailing Address - Phone:256-794-7387
Mailing Address - Fax:
Practice Address - Street 1:1308 SPRINGHILL RD
Practice Address - Street 2:
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-4457
Practice Address - Country:US
Practice Address - Phone:256-794-7387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care