Provider Demographics
NPI:1508621103
Name:GRANTED HOME CARE INC.
Entity Type:Organization
Organization Name:GRANTED HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DESIREA
Authorized Official - Middle Name:TANYA
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:215-881-3298
Mailing Address - Street 1:816 CHRISTIAN ST
Mailing Address - Street 2:
Mailing Address - City:GLASSBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08028-8393
Mailing Address - Country:US
Mailing Address - Phone:215-881-3298
Mailing Address - Fax:
Practice Address - Street 1:816 CHRISTIAN ST
Practice Address - Street 2:
Practice Address - City:GLASSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08028-8393
Practice Address - Country:US
Practice Address - Phone:215-881-3298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care