Healthcare Provider Details
I. General information
NPI: 1295654119
Provider Name (Legal Business Name): LOVE AND GRACE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
305 QUECREEK CIR STE 200
SMYRNA TN
37167-6811
US
IV. Provider business mailing address
305 QUECREEK CIR STE 200
SMYRNA TN
37167-6811
US
V. Phone/Fax
- Phone: 615-305-0036
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MOSES
ONWUBIKO
Title or Position: OWNER
Credential:
Phone: 615-305-0036