Organization
GOD'S GRACE L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY DE SHA (OWNER/MANAGER)
(314) 803-8364
Entity
Organization
Contact information
Practice address
6708 ROBBINS AVE, SAINT LOUIS, MO 63133-1623
(314) 803-8364
Mailing address
224 N HIGHWAY 67 STE 311, FLORISSANT, MO 63031-5904
(314) 803-8364
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
08/11/2011
Last updated
08/11/2011
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