# AMAZING GRACE HOME HEALTH CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275971095
- **Authorized official:** ANDREA NICCOYA JACKSON (OWNER/MANAGER)
- **Authorized official phone:** (757) 606-3170

## Contact information

- **Practice address:** 3940 AIRLINE BLVD, 118, CHESAPEAKE, VA 23321-3329
- **Practice address phone:** (757) 606-3170
- **Practice address fax:** (757) 606-3993
- **Mailing address:** 3940 AIRLINE BLVD, 118, CHESAPEAKE, VA 23321-3329
- **Mailing address phone:** (757) 606-3170
- **Mailing address fax:** (757) 606-3993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | HCO141040 | VA | Yes |

## Other

- **Enumeration date:** 06/14/2013
- **Last updated:** 07/24/2014