House of G.r.a.c.e.residential Services, LLC

NPI #1235750753 in Canton, Ohio

Provider Information

NPI Number: 1235750753
Entity Type: Organization
Organization Name: House of G.r.a.c.e.residential Services, LLC
Primary Specialty: Home Health
Enumeration Date: May 6, 2020
Last Updated: Nov 17, 2021

Practice Location

Address: 116 CLEVELAND AVE NW STE 555
Address 2: SUITE 555
City: Canton
State: Ohio
ZIP Code: 44702-1779
Phone: (330) 915-8347

Authorized Official

Name: AUDRA MARTIN, PHD , LISW-S
Title: CEO
Phone: (330) 915-8347

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Developmental Disabilities — Developmental Disabilities	261QD1600X
Home Health	251E00000X	Primary

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