Provider Demographics
NPI:1538922570
Name:GRACE GENERATION HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:GRACE GENERATION HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINACIAL OFFICAL
Authorized Official - Prefix:
Authorized Official - First Name:CYRUS
Authorized Official - Middle Name:WESSEH
Authorized Official - Last Name:GUEH
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:515-200-9559
Mailing Address - Street 1:2752 HOLCOMB AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-5559
Mailing Address - Country:US
Mailing Address - Phone:515-200-9559
Mailing Address - Fax:
Practice Address - Street 1:423 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-4615
Practice Address - Country:US
Practice Address - Phone:515-200-9559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-02
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, ChildGroup - Multi-Specialty