Provider Demographics
NPI:1871239384
Name:ENGRACE HOSPICE LLC
Entity type:Organization
Organization Name:ENGRACE HOSPICE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FABRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADJAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-207-8402
Mailing Address - Street 1:9507 NE GERTZ CIR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97211-1269
Mailing Address - Country:US
Mailing Address - Phone:971-207-8402
Mailing Address - Fax:
Practice Address - Street 1:512 SW QUINNEY PL
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-9461
Practice Address - Country:US
Practice Address - Phone:971-207-8402
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-08
Last Update Date:2022-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based