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General NPI Number Information
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NPI Number | 1952787509
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Entity Type | Organization
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Legal Business Name | AMAZING GRACE CARE SERVICES INC.
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Dates
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Enumeration Date | 08/05/2015
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Last Update Date | 08/13/2015
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Provider Practice Location Address
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Address Line | 4216 EVERGREEN LN #133
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City | ANNANDALE
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State | VA
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Zip | 22003-3243
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Country | US
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Telephone | 703-955-4913
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Fax | 571-327-5616
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Provider Business Mailing Address
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Address Line | 4216 EVERGREEN LN #133
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City | ANNANDALE
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State | VA
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Zip | 22003-3243
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Country | US
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Telephone | 703-955-4913
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Fax | 571-327-5616
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | JOSEPHINE ANDREWS-EGYRI
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Credential |
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Telephone | 703-955-4913
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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 | HCO161317
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License Number State | VA
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