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General NPI Number Information
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NPI Number | 1225975634
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Entity Type | Organization
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Legal Business Name | LIVING GRACE HOME CARE
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Dates
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Enumeration Date | 05/02/2026
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Last Update Date | 05/02/2026
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Provider Practice Location Address
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Address Line | 3712 CLARKS RIVER RD LOT 111
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City | PADUCAH
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State | KY
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Zip | 42003-0522
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Country | US
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Telephone | 270-209-9898
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 102
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City | PADUCAH
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State | KY
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Zip | 42002-0102
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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 | DEIDRA WILLIAMS
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Credential |
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Telephone | 270-209-9898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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