Provider Demographics
NPI:1922488345
Name:AMAZING GRACE HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:AMAZING GRACE HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ANYE
Authorized Official - Last Name:NWANCHA
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:240-478-5867
Mailing Address - Street 1:1300 I ST NW STE 400E
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20005-3318
Mailing Address - Country:US
Mailing Address - Phone:202-718-8942
Mailing Address - Fax:
Practice Address - Street 1:1300 I ST NW SUITE 400E
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005
Practice Address - Country:US
Practice Address - Phone:240-478-5867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-01
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health