MEDICARE: THE GRACE PROJECT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		FL

General Provider Information

NPI Number	:	1336327014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE GRACE PROJECT LLC

Provider Business Mailing Address
First Line	:	1915 N DALE MABRY HWY
Second Line	:	#406
City	:	TAMPA
State	:	FL
Zip	:	33607-2550
Country	:	US
Telephone Number	:	813-870-6700
Fax Number	:	813-870-6701

Provider Business Practice Location Address
First Line	:	1915 N DALE MABRY HWY
Second Line	:	#406
City	:	TAMPA
State	:	FL
Zip	:	33607-2550
Country	:	US
Telephone Number	:	813-870-6700
Fax Number	:	813-870-6701

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. ALISON LEE WHITE
Credential	:
Telephone Number	:	813-870-6700

Provider Enumeration Date	:	02/05/2008
Last Update Date	:	02/05/2008

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Directions to “THE GRACE PROJECT LLC ” Practice Location

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