Provider Demographics
NPI:1801808985
Name:GRACE REHAB, INC.
Entity type:Organization
Organization Name:GRACE REHAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BOBBY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-316-2525
Mailing Address - Street 1:PO BOX 251486
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-1486
Mailing Address - Country:US
Mailing Address - Phone:972-984-1851
Mailing Address - Fax:972-984-1859
Practice Address - Street 1:901 N MCDONALD ST
Practice Address - Street 2:SUITE 906
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-2143
Practice Address - Country:US
Practice Address - Phone:972-984-1851
Practice Address - Fax:972-984-1859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1218335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1774788-02Medicaid
TX1774788-01Medicaid