Provider Demographics
NPI:1881315521
Name:GRACE HEALTH WAY INC
Entity type:Organization
Organization Name:GRACE HEALTH WAY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:PROF
Authorized Official - First Name:ALEM
Authorized Official - Middle Name:
Authorized Official - Last Name:KEBEDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-432-7009
Mailing Address - Street 1:5300 LENNOX AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-1662
Mailing Address - Country:US
Mailing Address - Phone:661-432-7009
Mailing Address - Fax:661-432-7009
Practice Address - Street 1:5300 LENNOX AVE STE 100
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-1662
Practice Address - Country:US
Practice Address - Phone:661-432-7009
Practice Address - Fax:661-432-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health