Organization
OUR GRACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LACEISHA KING (OWNER)
(225) 505-1607
Entity
Organization
Contact information
Practice address
11940 BRICKSOME AVE STE D, BATON ROUGE, LA 70816-2594
(225) 505-1607
Mailing address
11940 BRICKSOME AVE STE D, BATON ROUGE, LA 70816-2594
(225) 505-1607
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1008478
—
LA
Enumeration date
10/29/2019
Last updated
10/29/2019
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