Provider Demographics
NPI:1326410945
Name:AMAZING GRACE HOMECARE LLC
Entity Type:Organization
Organization Name:AMAZING GRACE HOMECARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCOISE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHARLES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-718-8116
Mailing Address - Street 1:400 W CUMMINGS PARK
Mailing Address - Street 2:SUITE 3775
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-6369
Mailing Address - Country:US
Mailing Address - Phone:508-718-8116
Mailing Address - Fax:
Practice Address - Street 1:400 W CUMMINGS PARK
Practice Address - Street 2:SUITE 3775
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-6369
Practice Address - Country:US
Practice Address - Phone:508-718-8116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health