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General NPI Number Information
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NPI Number | 1750334934
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Entity Type | Organization
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Legal Business Name | AMAZING GRACE NURSING SERVICES, INC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9720 BEECHNUT ST SUITE 120
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City | HOUSTON
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State | TX
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Zip | 77036-6562
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Country | US
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Telephone | 713-484-7555
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Fax | 713-484-6318
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Provider Business Mailing Address
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Address Line | 9720 BEECHNUT ST. SUITE 120
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City | HOUSTON
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State | TX
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Zip | 77036-6654
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Country | US
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Telephone | 713-484-7555
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Fax | 713-484-6318
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Authorized Official
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Title or Position | ALT. ADMINISTRATOR
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Name | TIAMIYU TAJUDEEN
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Credential |
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Telephone | 713-484-7555
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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 | 009098
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License Number State | TX
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