Provider Demographics
NPI:1184039372
Name:GREAT GRACE HOME CARE AND BEHAVIORAL HEALTH, LLC
Entity type:Organization
Organization Name:GREAT GRACE HOME CARE AND BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:EGHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:412-294-3175
Mailing Address - Street 1:7422 MAPLE SPICE AVE
Mailing Address - Street 2:
Mailing Address - City:CANAL WINCHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:43110-8073
Mailing Address - Country:US
Mailing Address - Phone:412-294-3175
Mailing Address - Fax:
Practice Address - Street 1:5499 MESA RIDGE LN
Practice Address - Street 2:E
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6722
Practice Address - Country:US
Practice Address - Phone:412-294-3175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-25
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS1303301251B00000X, 251C00000X, 251S00000X, 253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care