Organization
AGE WITH GRACE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ILEA LYNNE BOUSE MS CMC (GERIATRIC CARE MANAGER/OWNER)
(541) 490-7039
Entity
Organization
Contact information
Practice address
2090 RIVERDALE RD, HOOD RIVER, OR 97031-8625
(541) 490-7039
Mailing address
1767 12TH ST # 199, HOOD RIVER, OR 97031-9531
(541) 490-7039
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
09/22/2010
Last updated
09/22/2010
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