# EXTENDED GRACE HOME HEALTHCARE, LLC

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

## Provider details

- **NPI number:** 1316374119
- **Authorized official:** PREETHI ABRAHAM (DIRECTOR OF CLIENT SERVICES)
- **Authorized official phone:** (817) 576-2408

## Contact information

- **Practice address:** 1605 BRANCHVIEW CT, KELLER, TX 76248-6833
- **Practice address phone:** (817) 576-2408
- **Practice address fax:** (817) 916-8802
- **Mailing address:** 8528 DAVIS BLVD \# 134-208, NORTH RICHLAND HILLS, TX 76182-8367

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 10/11/2013
- **Last updated:** 04/21/2014