Provider Demographics
NPI:1265740443
Name:GRACE HOME HEALTHCARE, LLC
Entity type:Organization
Organization Name:GRACE HOME HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMOLA
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:314-482-4826
Mailing Address - Street 1:18614 WHISKEY CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63069-2530
Mailing Address - Country:US
Mailing Address - Phone:314-482-4826
Mailing Address - Fax:636-458-6101
Practice Address - Street 1:18614 WHISKEY CREEK RD
Practice Address - Street 2:
Practice Address - City:WILDWOOD
Practice Address - State:MO
Practice Address - Zip Code:63069-2530
Practice Address - Country:US
Practice Address - Phone:314-482-4826
Practice Address - Fax:636-458-6101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health