Healthcare Provider Details

I. General information

NPI: 1598167652
Provider Name (Legal Business Name): GRACE PROVIDERS HOME HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2014
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5510 CHEROKEE AVE SUITE 250
ALEXANDRIA VA
22312-2320
US

IV. Provider business mailing address

4000 PARAMOUNT PARKWAY SUITE 100
MORRISVILLE NC
27560-4702
US

V. Phone/Fax

Practice location:
  • Phone: 703-845-2785
  • Fax: 571-282-4446
Mailing address:
  • Phone: 919-390-2980
  • Fax: 919-390-1888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHCO-151156
License Number StateVA

VIII. Authorized Official

Name: KENNETH DUARTE
Title or Position: CFO
Credential:
Phone: 336-553-5912