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General NPI Number Information
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NPI Number | 1033708961
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Entity Type | Organization
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Legal Business Name | SARAH GRACE HOME CARE
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 01/14/2021
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Provider Practice Location Address
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Address Line | 2835 CHAPMAN CT
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City | MARIETTA
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State | GA
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Zip | 30066-3673
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Country | US
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Telephone | 678-754-3533
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Fax |
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Provider Business Mailing Address
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Address Line | 2835 CHAPMAN CT
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City | MARIETTA
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State | GA
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Zip | 30066-3673
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Country | US
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Telephone | 678-754-3533
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ALLAN GITAU
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Credential | RN
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Telephone | 678-754-3533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number |
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License Number State |
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