Organization
GRACEFUL HEARTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOSHA PUGH (CEO)
(251) 387-5154
Entity
Organization
Contact information
Practice address
110 COMMERCE ST, JACKSON, AL 36545-2716
(251) 387-5154
Mailing address
110 COMMERCE ST, JACKSON, AL 36545-2716
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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