Provider Demographics
NPI:1023832516
Name:GRACE AND INTEGRITY COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:GRACE AND INTEGRITY COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PANDORA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-953-8907
Mailing Address - Street 1:4010 BARRETT DR STE G2
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6622
Mailing Address - Country:US
Mailing Address - Phone:919-609-9493
Mailing Address - Fax:
Practice Address - Street 1:4010 BARRETT DR STE G2
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6622
Practice Address - Country:US
Practice Address - Phone:919-609-9493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-11
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome HealthGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty