Organization
GRACE DIVINE, LLC
Active
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
08/11/2026
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