Provider Demographics
NPI:1033965256
Name:GRACE HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:GRACE HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIAS NJIRU
Authorized Official - Middle Name:NJIRU
Authorized Official - Last Name:KARENJU
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:402-237-6085
Mailing Address - Street 1:15508 KNUDSEN CIR
Mailing Address - Street 2:
Mailing Address - City:BENNINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68007-1914
Mailing Address - Country:US
Mailing Address - Phone:402-237-6085
Mailing Address - Fax:
Practice Address - Street 1:15508 KNUDSEN CIR
Practice Address - Street 2:
Practice Address - City:BENNINGTON
Practice Address - State:NE
Practice Address - Zip Code:68007-1914
Practice Address - Country:US
Practice Address - Phone:402-237-6085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE78299346Medicaid