Provider Demographics
NPI:1154078178
Name:GRACEFUL HANDS FAMILY HEALTH CARE LLC
Entity Type:Organization
Organization Name:GRACEFUL HANDS FAMILY HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:SONJA
Authorized Official - Middle Name:
Authorized Official - Last Name:MACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-901-9907
Mailing Address - Street 1:PO BOX 332
Mailing Address - Street 2:
Mailing Address - City:ST MATTHEWS
Mailing Address - State:SC
Mailing Address - Zip Code:29135-0332
Mailing Address - Country:US
Mailing Address - Phone:803-901-9907
Mailing Address - Fax:
Practice Address - Street 1:409 HARRY C RAYSOR DR
Practice Address - Street 2:
Practice Address - City:ST MATTHEWS
Practice Address - State:SC
Practice Address - Zip Code:29135-1481
Practice Address - Country:US
Practice Address - Phone:804-901-9907
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-09
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care