Provider Demographics
NPI:1952787509
Name:AMAZING GRACE CARE SERVICES INC.
Entity type:Organization
Organization Name:AMAZING GRACE CARE SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPHINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS-EGYRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-955-4913
Mailing Address - Street 1:4216 EVERGREEN LN
Mailing Address - Street 2:#133
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3243
Mailing Address - Country:US
Mailing Address - Phone:703-955-4913
Mailing Address - Fax:571-327-5616
Practice Address - Street 1:4216 EVERGREEN LN
Practice Address - Street 2:#133
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3243
Practice Address - Country:US
Practice Address - Phone:703-955-4913
Practice Address - Fax:571-327-5616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-05
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAHCO161317251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health