Grace Hospice of Fort Worth LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

GRACE HOSPICE OF FORT WORTH LLC

Practice address

4100 International PLZ
Suite 140
Fort Worth, TX 76109-4820

Phone

(817) 735-9600

Fax

(817) 735-4323

NPI assigned

Aug 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kirk Benton Wied

Title

Ceo

Phone

(817) 735-9600

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496880000000",
    "number": "1356598510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 INTERNATIONAL PLZ",
            "address_2": "SUITE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094820",
            "telephone_number": "817-735-9600",
            "fax_number": "817-735-4323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 INTERNATIONAL PLZ",
            "address_2": "SUITE 140",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761094820",
            "telephone_number": "817-735-9600",
            "fax_number": "817-735-4323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOSPICE OF FORT WORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2017-06-08",
        "status": "A",
        "authorized_official_last_name": "WIED",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "BENTON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-735-9600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica P Goyal, DO
• Simar Goyal
• Vikas Goyal, MD
• Kelsey Goynes
• Lesley Goynes, LCSW
• Richard Bradley Grace, CRNA
• Graced 2 Care, Arf Inc.
• Graceful Change Counseling Services
• Gracefully Aging
• Monica Rene Gracia, RN

• Community Based Hospice Care Agency in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Community Based Hospice Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.