Provider Demographics
NPI:1740946235
Name:GRACELAND HEALTH INC
Entity type:Organization
Organization Name:GRACELAND HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHUKWUEMEKA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBIEKWE
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:404-423-4438
Mailing Address - Street 1:1631 LAKEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:IL
Mailing Address - Zip Code:60561-4909
Mailing Address - Country:US
Mailing Address - Phone:404-423-4438
Mailing Address - Fax:
Practice Address - Street 1:1631 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:IL
Practice Address - Zip Code:60561-4909
Practice Address - Country:US
Practice Address - Phone:404-423-4438
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-10
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health