Organization
GRACIOUS LOVE IN HOME SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRALLE WILKINS (PRESIDENT/ADMINISTRATOR)
(618) 447-6535
Entity
Organization
Contact information
Practice address
267 S DADE AVE, FERGUSON, MO 63135-2522
(618) 477-6535
Mailing address
267 S DADE AVE, FERGUSON, MO 63135-2522
(618) 477-6535
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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