Provider Demographics
NPI:1457801391
Name:POINT OF GRACE HOME HEALTH
Entity Type:Organization
Organization Name:POINT OF GRACE HOME HEALTH
Other - Org Name:POINT OF GRACE GROUP LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:817-443-8775
Mailing Address - Street 1:606 ORIOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-3500
Mailing Address - Country:US
Mailing Address - Phone:817-443-8775
Mailing Address - Fax:
Practice Address - Street 1:2533 MILL SPRING PASS
Practice Address - Street 2:
Practice Address - City:FORT
Practice Address - State:TX
Practice Address - Zip Code:76123
Practice Address - Country:US
Practice Address - Phone:817-443-8775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX844153163W00000X, 251B00000X, 251E00000X, 251F00000X
251C00000X, 251F00000X, 347C00000X, 385HR2065X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251F00000XAgenciesHome Infusion
No347C00000XTransportation ServicesPrivate Vehicle
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child