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Organization
GRACE SUPPORTIVE LIVING SERVICES LLC
Active
Organization
GRACE SUPPORTIVE LIVING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SAMARA L ROBERTSON LPN (OWNER/LICENSE NURSE)
(770) 984-5388
Entity
Organization
Contact information
Practice address
3350 RIVERWOOD PKWY SE, 1900, ATLANTA, GA 30339-6401
(770) 984-5388
Mailing address
3350 RIVERWOOD PKWY SE, 1900, ATLANTA, GA 30339-6401
(770) 984-5388
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
NULL
253Z00000X
In Home Supportive Care Agency
LPN0089404
GA
Other
Enumeration date
02/09/2016
Last updated
02/18/2016
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