Provider Demographics
NPI:1760252217
Name:GRACE LOVE AGENCY LLC
Entity Type:Organization
Organization Name:GRACE LOVE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO / DON
Authorized Official - Prefix:
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:
Authorized Official - Last Name:WOOD-BARTELS
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN-BC
Authorized Official - Phone:856-520-9875
Mailing Address - Street 1:1003 SUNSET RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-2205
Mailing Address - Country:US
Mailing Address - Phone:856-520-9875
Mailing Address - Fax:
Practice Address - Street 1:1003 SUNSET RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08016-2205
Practice Address - Country:US
Practice Address - Phone:856-520-9875
Practice Address - Fax:732-510-5976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health