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General NPI Number Information
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NPI Number | 1538073937
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Entity Type | Organization
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Legal Business Name | GRACE IN HEALING HOME HEATH CARE AGENCY LLC
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Dates
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Enumeration Date | 10/01/2026
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Last Update Date | 10/01/2026
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Provider Practice Location Address
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Address Line | 2800 BUSH RIVER RD STE 3B
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City | COLUMBIA
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State | SC
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Zip | 29210-5662
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Country | US
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Telephone | 803-480-0356
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Fax |
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Provider Business Mailing Address
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Address Line | 806 HILLCREST DR
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City | JOHNSTON
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State | SC
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Zip | 29832-1327
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Country | US
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Telephone | 803-480-0356
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAKYSHA JONES
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Credential |
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Telephone | 803-480-0356
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State | NULL
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Taxonomy #2
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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 | NULL
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