Organization
GRACEY DE GREAT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACE IBRAHIM (MANAGER)
(832) 916-9215
Entity
Organization
Contact information
Practice address
3443 ADDICKS CLODINE RD APT 7108, HOUSTON, TX 77082-3089
(832) 916-9215
(346) 229-5954
Mailing address
PO BOX 820196, HOUSTON, TX 77282-0196
(832) 916-9215
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
11/16/2020
Last updated
12/21/2020
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