Provider Demographics
NPI:1144611567
Name:GRACE HOME CARE, LLC
Entity Type:Organization
Organization Name:GRACE HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAMSA
Authorized Official - Middle Name:
Authorized Official - Last Name:MURSHID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-265-6267
Mailing Address - Street 1:5827 COLUMBIA PIKE SUITE 211
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:22150
Mailing Address - Country:US
Mailing Address - Phone:571-265-6267
Mailing Address - Fax:571-266-5565
Practice Address - Street 1:5827 COLUMBIA PIKE SUITE 211
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:VA
Practice Address - Zip Code:22150
Practice Address - Country:US
Practice Address - Phone:571-265-6267
Practice Address - Fax:571-266-5565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health