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Organization
GRACE COMMUNITY CARE LLC
Active
Organization
GRACE COMMUNITY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK KOUASSI NOBOU (MANAGER)
(860) 538-8528
Entity
Organization
Contact information
Practice address
712 MARIETTA PL NW APT 103, WASHINGTON, DC 20011-3004
(203) 583-9412
(203) 549-9936
Mailing address
712 MARIETTA PL NW APT 103, WASHINGTON, DC 20011-3004
(203) 583-9412
(203) 549-9936
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
261QD1600X
Developmental Disabilities Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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