Provider Demographics
NPI:1982764262
Name:GRACE HEALTH CARE SERVICES INC.
Entity Type:Organization
Organization Name:GRACE HEALTH CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ONUOHA
Authorized Official - Middle Name:ONWUKA
Authorized Official - Last Name:CHUKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-217-8243
Mailing Address - Street 1:7308 WORSHAM DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-8366
Mailing Address - Country:US
Mailing Address - Phone:919-217-8243
Mailing Address - Fax:919-266-0755
Practice Address - Street 1:7308 WORSHAM DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-8366
Practice Address - Country:US
Practice Address - Phone:919-217-8243
Practice Address - Fax:919-266-0755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3462251E00000X, 251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251E00000XAgenciesHome Health
Not Answered251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6601544Medicaid
NC3418205Medicaid