Provider Demographics
NPI:1285201905
Name:GRACE AND MERCY SERVICES LLC
Entity Type:Organization
Organization Name:GRACE AND MERCY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIOS
Authorized Official - Prefix:MISS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:DOMINIQUE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-567-0162
Mailing Address - Street 1:3905 HILL GROVE LN APT H
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-7554
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 LIGHT ST
Practice Address - Street 2:
Practice Address - City:HEATHSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22473-3907
Practice Address - Country:US
Practice Address - Phone:571-719-7592
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-10
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health