Provider Demographics
NPI:1962643726
Name:GRANDCARE HOME HEALTH, LLC
Entity Type:Organization
Organization Name:GRANDCARE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ISAIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-439-7474
Mailing Address - Street 1:12100 FORD RD STE B318
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7243
Mailing Address - Country:US
Mailing Address - Phone:469-779-6406
Mailing Address - Fax:469-333-8002
Practice Address - Street 1:12100 FORD RD STE B318
Practice Address - Street 2:
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-7243
Practice Address - Country:US
Practice Address - Phone:469-779-6406
Practice Address - Fax:469-333-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-08
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health