Healthcare Provider Details

I. General information

NPI: 1588175111
Provider Name (Legal Business Name): GRACE FOR TODAY HOMECARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2017
Last Update Date: 06/20/2024
Certification Date: 06/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S MAIN ST
SARDIS MS
38666-1724
US

IV. Provider business mailing address

PO BOX 343
SARDIS MS
38666-0343
US

V. Phone/Fax

Practice location:
  • Phone: 622-301-2003
  • Fax: 662-857-2065
Mailing address:
  • Phone: 662-267-9673
  • Fax: 662-712-6040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DENISE CORBETT
Title or Position: OWNER
Credential:
Phone: 662-267-9673