| Grace Aging Services LLC | |
|
142 Richard Rd Leominster MA 01453-5985 | |
| (978) 870-8158 | |
| Not Available |
| Full Name | Grace Aging Services LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 142 Richard Rd, Leominster, Massachusetts |
| Authorized Official Name and Position | Denise R Tufts (SOLE MEMBER) |
| Authorized Official Contact | 9788708158 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Aging Services LLC 142 Richard Rd Leominster MA 01453-5985 Ph: (978) 870-8158 | Grace Aging Services LLC 142 Richard Rd Leominster MA 01453-5985 Ph: (978) 870-8158 |
| NPI Number | 1528504495 |
|---|---|
| Provider Enumeration Date | 01/16/2017 |
| Last Update Date | 01/16/2017 |
| Medicare PECOS PAC ID | 3173806916 |
|---|---|
| Medicare Enrollment ID | O20170201002797 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528504495 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 119558 (Massachusetts) | Primary |
| Provider Name | Stacey Jenee Rutherford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528168135 PECOS PAC ID: 6204825086 Enrollment ID: I20040507000493 |
| Provider Name | Denise Tufts |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013341585 PECOS PAC ID: 0042441123 Enrollment ID: I20140403000337 |
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