Organization
GRACE PERSONAL CARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LANTONA T. THORNTON RN (DIRECTOR)
(414) 264-4825
Entity
Organization
Contact information
Practice address
3246 N TEUTONIA AVE, MILWAUKEE, WI 53206-2265
(414) 264-4824
(414) 264-4825
Mailing address
PO BOX 6221, MILWAUKEE, WI 53206-0221
(414) 264-4824
(414) 264-4825
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
100011394
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100011394
—
WI
Enumeration date
07/03/2012
Last updated
07/03/2012
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