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Organization

GRACE CARE SER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHANELL S CODY (OWNER)
(863) 585-0147
Entity
Organization

Contact information

Practice address
395 E CENTRAL AVE, WINTER HAVEN, FL 33880-3047
(863) 585-0147
(863) 875-5348
Mailing address
395 E CENTRAL AVE, WINTER HAVEN, FL 33880-3047
(863) 585-0147
(863) 875-5348

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
253Z00000X
In Home Supportive Care Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
017257100
FL
Enumeration date
04/07/2016
Last updated
06/29/2023
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