Healthcare Provider Details

I. General information

NPI: 1871184408
Provider Name (Legal Business Name): GRACE MIRACLE HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2021
Last Update Date: 01/20/2022
Certification Date: 01/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3604 MILLER RD
WILMINGTON DE
19802-2524
US

IV. Provider business mailing address

3604 MILLER RD
WILMINGTON DE
19802-2524
US

V. Phone/Fax

Practice location:
  • Phone: 302-257-1079
  • Fax: 302-762-1647
Mailing address:
  • Phone: 302-257-1079
  • Fax: 302-762-1647

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. VICTORIA LAMPEY
Title or Position: ADMINSTRATOR
Credential:
Phone: 302-257-1079