Provider Demographics
NPI:1679098487
Name:AMAZING GRACE OF BOSTON HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:AMAZING GRACE OF BOSTON HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AYNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ATNAFU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-513-2880
Mailing Address - Street 1:194 SANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-3002
Mailing Address - Country:US
Mailing Address - Phone:617-513-2880
Mailing Address - Fax:
Practice Address - Street 1:194 SANDERSON AVE
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-3002
Practice Address - Country:US
Practice Address - Phone:617-513-2880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health