Provider Demographics
NPI:1649679986
Name:GRACEFUL HANDS HEALTH CARE SERVICES
Entity type:Organization
Organization Name:GRACEFUL HANDS HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:KEMOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-787-8912
Mailing Address - Street 1:6161 BUSCH BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-2508
Mailing Address - Country:US
Mailing Address - Phone:614-787-8912
Mailing Address - Fax:
Practice Address - Street 1:6161 BUSCH BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-2508
Practice Address - Country:US
Practice Address - Phone:614-787-8912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2304563251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2304563OtherBUSINESS LICENSE