Provider Demographics
NPI:1619503919
Name:CARING GRACE HOME CARE AGENCY LLC
Entity Type:Organization
Organization Name:CARING GRACE HOME CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BEATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:KARNGA-GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-443-1850
Mailing Address - Street 1:881 3RD ST STE B2
Mailing Address - Street 2:
Mailing Address - City:WHITEHALL
Mailing Address - State:PA
Mailing Address - Zip Code:18052-5922
Mailing Address - Country:US
Mailing Address - Phone:610-443-1850
Mailing Address - Fax:
Practice Address - Street 1:881 3RD ST STE B2
Practice Address - Street 2:
Practice Address - City:WHITEHALL
Practice Address - State:PA
Practice Address - Zip Code:18052-5922
Practice Address - Country:US
Practice Address - Phone:610-443-1850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-18
Last Update Date:2020-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1035928200002Medicaid