Healthcare Provider Details

I. General information

NPI: 1144139296
Provider Name (Legal Business Name): ANCHORED IN GRACE CASE MANAGEMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 JESTERS LAKE DR
JONESBORO GA
30236-2018
US

IV. Provider business mailing address

816 JESTERS LAKE DR
JONESBORO GA
30236-2018
US

V. Phone/Fax

Practice location:
  • Phone: 470-453-2111
  • Fax:
Mailing address:
  • Phone: 470-453-2111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: VANESSA BAZEMORE
Title or Position: AUTHORIZED OFFICAL
Credential: MASTERS DEGREE
Phone: 470-453-2111