Provider Demographics
NPI:1245946763
Name:GRACE HEALTH SYTEMS LLC
Entity type:Organization
Organization Name:GRACE HEALTH SYTEMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SANDHIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHARAJ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:602-466-8352
Mailing Address - Street 1:4627 E PEARCE RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-1126
Mailing Address - Country:US
Mailing Address - Phone:952-649-0366
Mailing Address - Fax:
Practice Address - Street 1:4627 E PEARCE RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-1126
Practice Address - Country:US
Practice Address - Phone:952-649-0366
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-27
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health