Grace Home Health Care, Inc

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

1011205 Issued in IL

Legal business name

GRACE HOME HEALTH CARE, INC

Practice address

625 E 170TH St Ste 1NE
South Holland, IL 60473-3481

Phone

(708) 566-4509

Fax

(708) 825-1372

NPI assigned

Jul 23, 2010

Organization subpart

No

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

Authorized official

Name

Fatmata Beckley, RN

Title

Agency Supervisor

Phone

(708) 566-4509

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Home health agency certification: CCN 148297

Legal name

GRACE HOME HEALTH CARE, INC.

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Dec 19, 2011

Last certification

Apr 2, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

Oct 9, 2008 in IL

Enrollment address

625 E 170TH St
Ste 1NE
South Holland, IL 60473-3481

Listed as

Grace Home Health Care, IncCCN 148297

Ownership

Proprietary

Certified

Dec 19, 2011

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648771200000",
    "number": "1841503448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 E 170TH ST STE 1NE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604733481",
            "telephone_number": "708-566-4509",
            "fax_number": "708-825-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 E 170TH ST STE 1NE",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604733481",
            "telephone_number": "708-566-4509",
            "fax_number": "708-825-1372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HOME HEALTH CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-23",
        "last_updated": "2022-04-01",
        "certification_date": "2022-04-01",
        "status": "A",
        "authorized_official_last_name": "BECKLEY",
        "authorized_official_first_name": "FATMATA",
        "authorized_official_title_or_position": "AGENCY SUPERVISOR",
        "authorized_official_telephone_number": "708-566-4509",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "IL",
            "license": "1011205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "1011878",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS LICENSE",
            "identifier": "1011205",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gods Grace Inc
• Arlene L Goodall, EARLYINTERVENTIONSPE
• Linda Gordon, CD(DONA)
• Shelbey Gordon
• Patrick Michael Gorman, D.D.S.
• Grand Prairie Services
• Grander Home Health Care and Billing Service Inc
• Richard Grevengoed, L.C.P.C.
• Jasper J Gulotta, O.D.
• Aarti Gupta

• Home Health Agency in South Holland, IL
• Providers in South Holland, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.