| NPI | 1558020008 |
|---|---|
| Former Legal Business Name | OUR HOME OF GRACE HOME CARE LLC |
| Entity Type | Organization |
| Authorized Contact | LAKESHA THOMPSON Owner 229-569-0423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251E00000X Home Health |
| Enumeration Date | 2021-12-13 |
| Last Update Date | 2021-12-13 |