Provider Demographics
NPI:1487226890
Name:ABOUNDING GRACE FAMILY CARE HOME, INCORPORATED
Entity Type:Organization
Organization Name:ABOUNDING GRACE FAMILY CARE HOME, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-500-4805
Mailing Address - Street 1:47 DRUMCASTLE CT
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-5639
Mailing Address - Country:US
Mailing Address - Phone:301-500-4805
Mailing Address - Fax:
Practice Address - Street 1:1012 FONTANA ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4627
Practice Address - Country:US
Practice Address - Phone:910-491-4470
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-14
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home