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General NPI Number Information
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NPI Number | 1699063263
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Entity Type | Organization
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Legal Business Name | BY GRACE HOME CARE AGENCY, LLC
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Dates
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Enumeration Date | 07/18/2011
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Last Update Date | 07/18/2011
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Provider Practice Location Address
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Address Line | 558A DENBIGH BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23608-4240
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Country | US
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Telephone | 757-833-0098
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Fax | 757-833-0098
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Provider Business Mailing Address
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Address Line | 558A DENBIGH BLVD
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City | NEWPORT NEWS
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State | VA
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Zip | 23608-4240
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Country | US
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Telephone | 757-833-0098
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Fax | 757-833-0098
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Authorized Official
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Title or Position | PRESIDENT/ADMINSTRATOR
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Name | MRS. PEGGY ROMERO
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Credential | RN
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Telephone | 757-833-0098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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