Provider Demographics
NPI:1518668771
Name:AA3 GGRACE HOME CARE LLC
Entity Type:Organization
Organization Name:AA3 GGRACE HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NGONDA-YEBENIT
Authorized Official - Middle Name:
Authorized Official - Last Name:NGOMAYEBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-430-9120
Mailing Address - Street 1:329 SANFORD DR STE A
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-2576
Mailing Address - Country:US
Mailing Address - Phone:828-608-0956
Mailing Address - Fax:828-430-9122
Practice Address - Street 1:329 SANFORD DR STE A
Practice Address - Street 2:
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-2576
Practice Address - Country:US
Practice Address - Phone:828-608-0956
Practice Address - Fax:828-430-9122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-15
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health