Provider Demographics
NPI:1598430100
Name:CARING HEARTS OF GRACE HOMECARE AGENCY, LLC
Entity Type:Organization
Organization Name:CARING HEARTS OF GRACE HOMECARE AGENCY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEQUITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMMONS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:980-334-5367
Mailing Address - Street 1:1085 HEARTH LN SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-8809
Mailing Address - Country:US
Mailing Address - Phone:980-237-8845
Mailing Address - Fax:980-237-8845
Practice Address - Street 1:294 CHURCH ST N
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-4571
Practice Address - Country:US
Practice Address - Phone:980-237-8845
Practice Address - Fax:980-237-8845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-16
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care