Provider Demographics
NPI:1295459782
Name:BY GOD'S GRACE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:BY GOD'S GRACE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:T
Authorized Official - Last Name:GOODRICH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:757-675-0331
Mailing Address - Street 1:2 CANOE CT
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23703-5380
Mailing Address - Country:US
Mailing Address - Phone:757-675-0331
Mailing Address - Fax:757-485-7833
Practice Address - Street 1:2 CANOE CT
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23703-5380
Practice Address - Country:US
Practice Address - Phone:757-675-0331
Practice Address - Fax:757-485-7833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-28
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health