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General NPI Number Information
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NPI Number | 1871924332
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Entity Type | Organization
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Legal Business Name | SAVING GRACE HEALTH CARE SERVICES LLC
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Dates
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Enumeration Date | 12/10/2013
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Last Update Date | 12/10/2013
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Provider Practice Location Address
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Address Line | 20139 PALM BLVD
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City | COVINGTON
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State | LA
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Zip | 70435-6453
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Country | US
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Telephone | 985-249-4448
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Fax |
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Provider Business Mailing Address
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Address Line | 20139 PALM BLVD
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City | COVINGTON
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State | LA
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Zip | 70435-6453
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Country | US
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Telephone | 985-249-4448
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | VALERIE LYNETTE GRAYSON
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Credential | LPN
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Telephone | 985-249-4448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 290308
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License Number State | LA
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