Organization
AMAZING GRACE PERSONAL CARE SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONDA M. CARSON BSN (EXECUTIVE DIRECTOR)
(478) 746-1133
Entity
Organization
Contact information
Practice address
2449 VINEVILLE AVE, SUITE 7, MACON, GA 31204-2955
(478) 746-1133
(478) 746-9933
Mailing address
2449 VINEVILLE AVE, SUITE 7, MACON, GA 31204-2955
(478) 746-1133
(478) 746-9933
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
084-R-0002
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000770195A
—
GA
05
—
000770195B
—
GA
Enumeration date
11/09/2010
Last updated
12/16/2010
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