Provider Demographics
NPI:1891926549
Name:GRACELAND HOSPICE AND HOME HEALTH LLC
Entity Type:Organization
Organization Name:GRACELAND HOSPICE AND HOME HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-624-0031
Mailing Address - Street 1:703 TITUS ST
Mailing Address - Street 2:
Mailing Address - City:GILMER
Mailing Address - State:TX
Mailing Address - Zip Code:75644-1738
Mailing Address - Country:US
Mailing Address - Phone:903-843-5529
Mailing Address - Fax:903-680-2175
Practice Address - Street 1:703 TITUS ST
Practice Address - Street 2:
Practice Address - City:GILMER
Practice Address - State:TX
Practice Address - Zip Code:75644-1738
Practice Address - Country:US
Practice Address - Phone:903-843-5529
Practice Address - Fax:903-680-2175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based