Provider Demographics
NPI:1457239485
Name:HEART GRACE CARES FOUNDATION
Entity type:Organization
Organization Name:HEART GRACE CARES FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER/ CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:EDISON
Authorized Official - Last Name:BRUCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-312-3632
Mailing Address - Street 1:1000 PASEO CAMARILLO STE 125
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6021
Mailing Address - Country:US
Mailing Address - Phone:805-388-1158
Mailing Address - Fax:
Practice Address - Street 1:1000 PASEO CAMARILLO STE 125
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6021
Practice Address - Country:US
Practice Address - Phone:805-388-1158
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health