Healthcare Provider Details

I. General information

NPI: 1760345342
Provider Name (Legal Business Name): GRACE ABOUNDS HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1389C CLIFF GOOKIN BLVD
TUPELO MS
38801-6458
US

IV. Provider business mailing address

1635 OLD HIGHWAY 41 NW STE 112-130
KENNESAW GA
30152-4480
US

V. Phone/Fax

Practice location:
  • Phone: 770-241-5924
  • Fax:
Mailing address:
  • Phone: 770-241-5294
  • Fax:

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 Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KEISHA SMITH
Title or Position: OWNER
Credential:
Phone: 770-681-3555