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Organization

AMAZING GRACE HOME HEALTH CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREA NICCOYA JACKSON (OWNER/MANAGER)
(757) 606-3170
Entity
Organization

Contact information

Practice address
3940 AIRLINE BLVD, 118, CHESAPEAKE, VA 23321-3329
(757) 606-3170
(757) 606-3993
Mailing address
3940 AIRLINE BLVD, 118, CHESAPEAKE, VA 23321-3329
(757) 606-3170
(757) 606-3993

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCO141040
VA

Other

Enumeration date
06/14/2013
Last updated
07/24/2014
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