Provider Demographics
NPI:1083489827
Name:ASSISTED WITH GRACE LLC
Entity Type:Organization
Organization Name:ASSISTED WITH GRACE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANIIYKA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:803-983-3967
Mailing Address - Street 1:2235 STADIUM RD
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-6142
Mailing Address - Country:US
Mailing Address - Phone:803-983-3967
Mailing Address - Fax:
Practice Address - Street 1:2235 STADIUM RD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154-6142
Practice Address - Country:US
Practice Address - Phone:803-983-3967
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-21
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)