Organization
HIS GRACE HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADENIKE EMOSU (OWNER)
(678) 362-3094
Entity
Organization
Contact information
Practice address
5202 FAIRINGTON VILLAGE DR, LITHONIA, GA 30038-1371
(678) 362-3094
Mailing address
PO BOX 1402, LITHONIA, GA 30058-1000
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/12/2021
Last updated
10/12/2021
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