Organization
GRACE DIVINE, LLC
Active
Other names
Grace At Home, Primary Care House Calls, Grace at Home
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODNEY C ARMSTEAD MD (CEO)
(310) 418-7250
Entity
Organization
Contact information
Practice address
8900 KEYSTONE XING STE 540, INDIANAPOLIS, IN 46240-2130
(317) 429-0120
(317) 800-7730
Mailing address
8900 KEYSTONE XING STE 540, INDIANAPOLIS, IN 46240-2130
(317) 429-0120
(317) 800-7730
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38836
KY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
38836
KY
208D00000X
General Practice Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300082847
—
IN
Enumeration date
10/29/2009
Last updated
04/10/2026
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