Provider Demographics
NPI:1942508601
Name:PARTNERS IN GRACE
Entity Type:Organization
Organization Name:PARTNERS IN GRACE
Other - Org Name:OUR HEARTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BORODYANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-495-6000
Mailing Address - Street 1:2222 DEER MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-7152
Mailing Address - Country:US
Mailing Address - Phone:972-495-6000
Mailing Address - Fax:972-692-5164
Practice Address - Street 1:3241 DANIELDALE RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75134-1519
Practice Address - Country:US
Practice Address - Phone:972-228-0960
Practice Address - Fax:972-692-5164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-04
Last Update Date:2011-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care