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General NPI Number Information
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NPI Number | 1831985498
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Entity Type | Organization
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Legal Business Name | GRACE SENIOR HOME HEALTHCARE LLC
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Dates
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Enumeration Date | 04/18/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 125 GREGG ST
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City | CHESAPEAKE
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State | VA
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Zip | 23320-6315
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Country | US
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Telephone | 757-502-3672
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Fax |
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Provider Business Mailing Address
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Address Line | 504 GLORIA DR
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City | CHESAPEAKE
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State | VA
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Zip | 23322-9138
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Country | US
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Telephone | 757-502-3672
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Fax |
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Authorized Official
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Title or Position | ADMINSITRATOR
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Name | MRS. TRACYE HARRIS
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Credential | MBA
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Telephone | 757-502-3672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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