# MY GRANDPARENTS HOUSE

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

## Provider details

- **NPI number:** 1770176356
- **Authorized official:** MS. SOPHIA PRISCILLA PEART (OWNER)
- **Authorized official phone:** (862) 334-9703

## Contact information

- **Practice address:** 3284 LANDING VW, TAVARES, FL 32778-2035
- **Practice address phone:** (862) 334-9703
- **Mailing address:** 220 STRAIGHT ST APT 311, PATERSON, NJ 07501-1953

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 02/16/2021
- **Last updated:** 02/16/2021