Organization
C & AW LIMITED LIABILITY COMPANY
Active
Other names
Grace Home Care & Behavioral Service
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA LORRAINE WILLIAMS (ADMINISTRATOR)
(803) 719-0292
Entity
Organization
Contact information
Practice address
3508 SIDNEY RD., COLUMBIA, SC 29210-4437
(803) 719-0292
Mailing address
1312 CEDAR CREEK RD., BLYTHEWOOD, SC 29016-8655
(803) 719-0292
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/21/2012
Last updated
02/01/2012
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