# HOUSE OF GRACE PERSONAL CARE HOME

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

## Provider details

- **NPI number:** 1639368129
- **Authorized official:** MR. JEAN P STFLEUR (ADMINISTRATOR)
- **Authorized official phone:** (404) 549-0877

## Contact information

- **Practice address:** 80 JENNA LN, COVINGTON, GA 30016-6645
- **Practice address phone:** (404) 549-0877
- **Mailing address:** 80 JENNA LN, COVINGTON, GA 30016-6645
- **Mailing address phone:** (404) 549-0877

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | GA | Yes |

## Other

- **Enumeration date:** 10/19/2007
- **Last updated:** 10/19/2007