Healthcare Provider Details

I. General information

NPI: 1114200649
Provider Name (Legal Business Name): GRACE OF GOD HEALTHCARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2011
Last Update Date: 09/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6210 N CAPITOL ST NW
WASHINGTON DC
20011-1416
US

IV. Provider business mailing address

6210 N CAPITOL ST NW
WASHINGTON DC
20011-1416
US

V. Phone/Fax

Practice location:
  • Phone: 240-350-7378
  • Fax:
Mailing address:
  • Phone: 240-350-7378
  • Fax: 202-330-5605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateDC

VIII. Authorized Official

Name: ROSEALIND PHILIPS
Title or Position: OWNER
Credential: RN
Phone: 240-350-7378