Provider Demographics
NPI:1356524896
Name:GRACE HOME CARE SERVICES
Entity type:Organization
Organization Name:GRACE HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALEJANDRO
Authorized Official - Middle Name:C
Authorized Official - Last Name:CASASOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-545-4111
Mailing Address - Street 1:127 SOUTH BRAND BOULEVARD
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204
Mailing Address - Country:US
Mailing Address - Phone:818-545-4111
Mailing Address - Fax:818-545-8111
Practice Address - Street 1:127 SOUTH BRAND BOULEVARD
Practice Address - Street 2:SUITE 100B
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204
Practice Address - Country:US
Practice Address - Phone:818-545-4111
Practice Address - Fax:818-545-8111
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRACE HOME CARE SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-06
Last Update Date:2007-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health