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General NPI Number Information
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NPI Number | 1437871738
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Entity Type | Organization
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Legal Business Name | GRACE & FAITH CARE AGENCY LLC
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Dates
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Enumeration Date | 09/13/2022
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Last Update Date | 10/27/2022
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Provider Practice Location Address
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Address Line | 213 KERNEYWOOD ST STE 8
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City | LAKELAND
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State | FL
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Zip | 33803-2947
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Country | US
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Telephone | 863-608-6831
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Fax |
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Provider Business Mailing Address
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Address Line | 213 KERNEYWOOD ST STE 8
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City | LAKELAND
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State | FL
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Zip | 33803-2947
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Country | US
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Telephone | 863-608-6831
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DIANELYS REYES
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Credential |
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Telephone | 863-808-3994
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3747A0650X
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Taxonomy Name | Attendant Care Provider
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License Number |
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License Number State |
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