# AGING GRACE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063183804
- **Authorized official:** ANDREA L DEJESUS (CEO)
- **Authorized official phone:** (216) 203-0429

## Contact information

- **Practice address:** 3837 WOODRIDGE RD, CLEVELAND HEIGHTS, OH 44121-1815
- **Practice address phone:** (216) 203-0429
- **Mailing address:** 3837 WOODRIDGE RD, CLEVELAND HEIGHTS, OH 44121-1815
- **Mailing address phone:** (216) 203-0428

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171M00000X | Case Manager/Care Coordinator | — | NULL | — |
| 171M00000X | Case Manager/Care Coordinator | — | — | — |
| 172V00000X | Community Health Worker | — | NULL | — |
| 172V00000X | Community Health Worker | — | — | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 372600000X | Adult Companion | — | NULL | Yes |
| 372600000X | Adult Companion | — | — | Yes |
| 374U00000X | Home Health Aide | — | NULL | — |
| 374U00000X | Home Health Aide | — | — | — |
| 376J00000X | Homemaker | — | NULL | — |
| 376J00000X | Homemaker | — | — | — |
| 376K00000X | Nurse's Aide | — | NULL | — |
| 376K00000X | Nurse's Aide | — | — | — |

## Other

- **Enumeration date:** 09/22/2021
- **Last updated:** 07/01/2022