Provider Demographics
NPI:1780205252
Name:GRACE HOMECARE LLC
Entity type:Organization
Organization Name:GRACE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAWK
Authorized Official - Middle Name:
Authorized Official - Last Name:HNIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-307-2396
Mailing Address - Street 1:8686 MADISON AVE STE C
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-7203
Mailing Address - Country:US
Mailing Address - Phone:317-893-4527
Mailing Address - Fax:312-782-5496
Practice Address - Street 1:8686 MADISON AVE STE C
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-7203
Practice Address - Country:US
Practice Address - Phone:317-893-4527
Practice Address - Fax:317-825-4967
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-06
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care