Provider Demographics
NPI:1720407216
Name:AMAZING GRACE CARE INC
Entity Type:Organization
Organization Name:AMAZING GRACE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ARUNMA
Authorized Official - Middle Name:B CHRISTY
Authorized Official - Last Name:OGBUAGU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-578-6007
Mailing Address - Street 1:5388 SPRINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-3536
Mailing Address - Country:US
Mailing Address - Phone:404-578-6007
Mailing Address - Fax:678-801-6529
Practice Address - Street 1:5388 SPRINGBROOK DR
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-3536
Practice Address - Country:US
Practice Address - Phone:404-578-6007
Practice Address - Fax:678-801-6529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033-R-1078251J00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251J00000XAgenciesNursing Care