# D-VINE GRACE HOME HEALTH CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Home Health Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174972376
- **Authorized official:** MRS. NICKY CHARLES (CEO/OWNER)
- **Authorized official phone:** (757) 673-0796

## Contact information

- **Practice address:** 114 CHOWAN DR, A, PORTSMOUTH, VA 23701-2452
- **Practice address phone:** (757) 673-0796
- **Mailing address:** 114 CHOWAN DR, A, PORTSMOUTH, VA 23701-2452

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HCO-161264 | VA | Yes |

## Other

- **Enumeration date:** 06/08/2016
- **Last updated:** 06/08/2016