Organization
MOUNTAIN OF GRACE HOMEHEALTH,LLC
Active
Other names
Mountain Of Grace Homehealth,LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PATRICIA NEYOR MULUBAH (CEO)
(817) 386-0223
Entity
Organization
Contact information
Practice address
9533 JEREMIAH DR, FORT WORTH, TX 76108-5925
(817) 386-0223
Mailing address
PO BOX 151242, FORT WORTH, TX 76108-5242
(817) 386-0223
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
MEDICARE DOES NOT RECOGNIZED PERSONAL ASSISTANT SERVICE
—
Enumeration date
08/17/2022
Last updated
06/21/2023
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