Provider Demographics
NPI:1942953542
Name:GRACE RACE PALLIATIVE HOSPICE LLC
Entity Type:Organization
Organization Name:GRACE RACE PALLIATIVE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:INGRID
Authorized Official - Middle Name:
Authorized Official - Last Name:LEAVITT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:713-513-0095
Mailing Address - Street 1:6001 SAVOY DR STE 205
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3322
Mailing Address - Country:US
Mailing Address - Phone:713-513-0095
Mailing Address - Fax:
Practice Address - Street 1:6001 SAVOY DR STE 205
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3322
Practice Address - Country:US
Practice Address - Phone:713-513-0095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-02
Last Update Date:2023-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based