Healthcare Provider Details

I. General information

NPI: 1447698030
Provider Name (Legal Business Name): GRACE & LOVE HOME HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2013
Last Update Date: 06/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4567 ROCKBRIDGE RD UNIT 695
PINE LAKE GA
30072-1908
US

IV. Provider business mailing address

4587 ABERDEEN LN
STONE MTN GA
30083-4321
US

V. Phone/Fax

Practice location:
  • Phone: 404-915-7660
  • Fax:
Mailing address:
  • Phone: 404-680-8920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MS. DEBORAH WILLIAMS
Title or Position: CEO/CNA
Credential:
Phone: 404-915-7660