Organization
HIS GRACE HOME HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLENDA DIANA BAILEY-WHIGHAM (OWNER)
(757) 390-9174
Entity
Organization
Contact information
Practice address
1215 FLORIDA AVE, PORTSMOUTH, VA 23707-3403
(757) 390-9174
Mailing address
1215 FLORIDA AVE, PORTSMOUTH, VA 23707-3403
(757) 390-9174
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
S5562972
VA
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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