Individual
GRACE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
628 S DIAMOND ST, RAVENNA, OH 44266-2808
(216) 624-3720
Mailing address
628 S DIAMOND ST FRNT HOUSE, RAVENNA, OH 44266-2808
(216) 624-3720
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
—
OH
372600000X
Adult Companion
—
OH
3747P1801X
Personal Care Attendant
Primary
—
OH
376J00000X
Homemaker
—
OH
Other
Enumeration date
04/30/2026
Last updated
04/30/2026
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