House Of G.R.A.C.E.Residential Services, Llc

LBN: House Of G.R.A.C.E.Residential Services, Llc
House Of G.R.A.C.E.Residential Services, Llc is an health care organization with primary practice located at 116 Cleveland Ave Nw Ste 555 Suite 555, Canton OH 44702-1779. The organization recently has 2 registered licenses in different health care specialties including Agencies / Home Health, Ambulatory Health Care Facilities / Developmental Disabilities. Agencies / Home Health is the primary health care specialty. House Of G.R.A.C.E.Residential Services, Llc can be contacted via phone (330) 915-8347, or through Martin, Audra via phone (330) 915-8347.

Contact Information

Primary practice address
116 Cleveland Ave Nw Ste 555 Suite 555 Canton OH 44702-1779
Phone: (330) 915-8347
Fax: (330) 915-6030
Website:
Map and Directions
Authorized official contact:
Name: Martin, Audra PHD , LISW-S
Phone: (330) 915-8347

Health care specialties

SpecialtyCodeLicense #State
Agencies / Home Health 251E00000X
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X

Profile Details

NPI number 1235750753
LBN Legal business name House Of G.R.A.C.E.Residential Services, Llc
DBA Doing business as
Authorized official Martin, Audra PHD , LISW-S
Entity Organization
Organization subpart 1 No
Enumeration date May 6th, 2020
Last updated Nov 17th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235750753 NPPES
Ohio Other 7610455 OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES
Ohio MEDICAID 0215619 OHIO DEPARTMENT OF DEVELOPMENTAL DISABILITIES

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