Organization
AMAZING GRACE PERSONAL CARE SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM CRIDER M. DIV (OWNER)
(505) 796-4900
Entity
Organization
Contact information
Practice address
4131 BARBARA LOOP SE # 2D, RIO RANCHO, NM 87124-1362
(505) 796-4900
(505) 896-4513
Mailing address
4131 BARBARA LOOP SE # 2D, RIO RANCHO, NM 87124-1362
(505) 863-5898
(505) 896-4513
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
62985736
—
NM
Enumeration date
05/15/2007
Last updated
09/27/2024
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