Organization
GRACE CARE MEDICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL GEBRESILASSIE (SOLE OWNER)
(463) 999-4054
Entity
Organization
Contact information
Practice address
801 SHELBY ST, INDIANAPOLIS, IN 46203-1163
(463) 999-4054
Mailing address
801 SHELBY ST, INDIANAPOLIS, IN 46203-1163
(463) 999-4054
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/07/2025
Last updated
01/07/2025
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