Organization
GRACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GRACE TITILOLA LADIPO (LICENSED PRACTICAL NURSE)
(614) 554-6671
Entity
Organization
Contact information
Practice address
8590 CRANBERRY LN, PICKERINGTON, OH 43147-9441
(614) 554-6671
Mailing address
8590 CRANBERRY LN, PICKERINGTON, OH 43147-9441
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
137701
OH
320700000X
Physical Disabilities Residential Treatment Facility
Primary
137701
OH
Other
Enumeration date
05/19/2010
Last updated
05/19/2010
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