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General NPI Number Information
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NPI Number | 1194056952
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Entity Type | Organization
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Legal Business Name | A TOUCH OF GRACE HOME CARE AGENCY, INC.
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 01/19/2010
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Provider Practice Location Address
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Address Line | 311 CEDAR GLEN DR
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City | LAKE ALFRED
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State | FL
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Zip | 33850-2024
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Country | US
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Telephone | 863-268-3358
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Fax |
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Provider Business Mailing Address
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Address Line | 311 CEDAR GLEN DR
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City | LAKE ALFRED
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State | FL
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Zip | 33850-2024
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CARMEN MERCADO
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Credential |
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Telephone | 863-268-3358
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 231423
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License Number State | FL
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