Organization
GRACE HOME HEALTH CARE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FATMATA BECKLEY RN (AGENCY SUPERVISOR)
(708) 566-4509
Entity
Organization
Contact information
Practice address
625 E 170TH ST STE 1NE, SOUTH HOLLAND, IL 60473-3481
(708) 566-4509
(708) 825-1372
Mailing address
625 E 170TH ST STE 1NE, SOUTH HOLLAND, IL 60473-3481
(708) 566-4509
(708) 825-1372
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1011205
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1011205
ILLINOIS LICENSE
IL
01
—
1011878
ILLINOIS LICENSE
IL
Enumeration date
07/23/2010
Last updated
04/01/2022
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