Provider Demographics
NPI:1033708961
Name:SARAH GRACE HOME CARE
Entity Type:Organization
Organization Name:SARAH GRACE HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GITAU
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:678-754-3533
Mailing Address - Street 1:2835 CHAPMAN CT
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-3673
Mailing Address - Country:US
Mailing Address - Phone:678-754-3533
Mailing Address - Fax:
Practice Address - Street 1:2835 CHAPMAN CT
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-3673
Practice Address - Country:US
Practice Address - Phone:678-754-3533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No163WC1500XNursing Service ProvidersRegistered NurseCommunity HealthGroup - Multi-Specialty
No251G00000XAgenciesHospice Care, Community Based
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAPHCP010604OtherPRIVATE HOME CARE PROVIDER