Healthcare Provider Details

I. General information

NPI: 1376232371
Provider Name (Legal Business Name): GRATEFUL HEARTS HOME CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

179 S GRACE ST
ROCKY MOUNT NC
27804-5602
US

IV. Provider business mailing address

709 WESTWOOD DR
ROCKY MOUNT NC
27803-2529
US

V. Phone/Fax

Practice location:
  • Phone: 252-740-4075
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SHARON EASON
Title or Position: OWNER
Credential:
Phone: 252-740-4075