Organization
C & A W (SC) LIMITED LIABILITY COMPANY
Active
Other names
Grace Home Care & Behavioral Services
Organization subpart
No
Provider details
NPI number
Authorized official
KANDICE WILLIAMS (MANAGER)
(678) 887-2991
Entity
Organization
Contact information
Practice address
2553 OLD COVINGTON RD NE, CONYERS, GA 30013-1413
(678) 887-2991
Mailing address
2553 OLD COVINGTON RD NE, CONYERS, GA 30013-1413
(678) 887-2991
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
3747A0650X
Attendant Care Provider
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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