Provider Demographics
NPI:1154094043
Name:GRACE AND GLORY HOME CARE LLC
Entity Type:Organization
Organization Name:GRACE AND GLORY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ELLERBEE-STRONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-439-4751
Mailing Address - Street 1:2699 HIGHWAY 38 N
Mailing Address - Street 2:
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512-5034
Mailing Address - Country:US
Mailing Address - Phone:843-439-4751
Mailing Address - Fax:
Practice Address - Street 1:2699 HIGHWAY 38 N
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-5034
Practice Address - Country:US
Practice Address - Phone:843-439-4751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-27
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Single Specialty