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NPI Code Detail

MEDICARE: GRACE & MERCY HOMECARE LLC

MEDICARE: GRACE & MERCY HOMECARE LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251C00000XDevelopmentally Disabled Services Day Training Agency
2347C00000XPrivate Vehicle
3347E00000XTransportation Broker
4372600000XAdult Companion
5385H00000XRespite Care
6253Z00000XIn Home Supportive Care Agency

General Provider Information

NPI Number : 1568133098
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRACE & MERCY HOMECARE LLC
Provider Business Mailing Address
First Line : PO BOX 391622
Second Line :
City : DELTONA
State : FL
Zip : 32739-1622
Country : US
Telephone Number : 386-320-3449
Fax Number : 386-917-1962
Provider Business Practice Location Address
First Line : 6501 ARLINGTON EXPY STE B105
Second Line :
City : JACKSONVILLE
State : FL
Zip : 32211-0810
Country : US
Telephone Number : 386-320-3449
Fax Number : 386-917-1962
Authorized Official
Title or Position : ADMINISTRATOR
Name : SHAWNTA JOSEPH
Credential :
Telephone Number : 386-320-3449
Provider Enumeration Date : 09/23/2021
Last Update Date : 10/20/2021

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Directions to “GRACE & MERCY HOMECARE LLC ” Practice Location

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