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Organization
GRACE HOME REHAB SERVICES LLC
Active
Organization
GRACE HOME REHAB SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL BOTROS DPT (OWNER)
(732) 725-7040
Entity
Organization
Contact information
Practice address
2620 S UNIVERSITY DR APT 307, DAVIE, FL 33328-1472
(732) 725-7040
Mailing address
2620 S UNIVERSITY DR APT 307, DAVIE, FL 33328-1472
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
251E00000X
Home Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1871130559
NPI
—
Enumeration date
04/11/2021
Last updated
04/11/2021
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