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Organization

CHRISTY GRACE HEALTH CENTER INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. OYEN JOSHUA BORNGT IYAMU (CEO)
(512) 586-9963
Entity
Organization

Contact information

Practice address
2000 S IH 35 STE Q8C, ROUND ROCK, TX 78681-6917
(512) 586-9963
(512) 271-8358
Mailing address
2000 S IH 35 STE Q8C, ROUND ROCK, TX 78681-6917
(512) 586-9963
(512) 271-8358

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
251J00000X
Nursing Care Agency
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
363595501
TX
Enumeration date
08/17/2015
Last updated
06/02/2021
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