Provider Demographics
NPI:1952704645
Name:WITH GRACE MINISTRIES INC.
Entity Type:Organization
Organization Name:WITH GRACE MINISTRIES INC.
Other - Org Name:WITH GRACE HOSPICE AND PALLIATIVE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE SECRETARY
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINH
Authorized Official - Middle Name:N
Authorized Official - Last Name:LE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:408-600-4833
Mailing Address - Street 1:1879 LUNDY AVE
Mailing Address - Street 2:SUITE 233
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-1856
Mailing Address - Country:US
Mailing Address - Phone:408-649-6712
Mailing Address - Fax:
Practice Address - Street 1:1879 LUNDY AVE
Practice Address - Street 2:SUITE 233
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-1856
Practice Address - Country:US
Practice Address - Phone:408-649-6712
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based