Provider Demographics
NPI:1295885077
Name:ALL BY GRACE HOME HEALTH CARE, INC.
Entity type:Organization
Organization Name:ALL BY GRACE HOME HEALTH CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:OLABISI
Authorized Official - Last Name:SAMUELS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:214-550-0215
Mailing Address - Street 1:1402 CORINTH ST
Mailing Address - Street 2:SUITE 113
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75215-2111
Mailing Address - Country:US
Mailing Address - Phone:214-550-0215
Mailing Address - Fax:214-550-0885
Practice Address - Street 1:1402 CORINTH ST
Practice Address - Street 2:SUITE 113
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75215-2111
Practice Address - Country:US
Practice Address - Phone:214-550-0215
Practice Address - Fax:214-550-0885
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010939251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health