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General NPI Number Information
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NPI Number | 1922954916
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Entity Type | Organization
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Legal Business Name | GRACE FAMILY CARE LLC
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Dates
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Enumeration Date | 03/10/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 1101 HILLCREST PKWY STE E
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City | DUBLIN
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State | GA
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Zip | 31021-3579
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Country | US
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Telephone | 478-205-5517
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Fax | 478-205-5518
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Provider Business Mailing Address
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Address Line | 1101 HILLCREST PKWY STE E
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City | DUBLIN
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State | GA
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Zip | 31021-3579
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Country | US
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Telephone | 478-205-5517
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Fax | 478-205-5518
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Authorized Official
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Title or Position | CEO
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Name | SANDY SOUZA
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Credential | MD
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Telephone | 478-205-5517
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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