Organization
ADDOM, INC.
Active
Other names
Amazing Grace Home Health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DOMIQUE PACLIBAR RN (VICE-PRESIDENT)
(510) 243-9987
Entity
Organization
Contact information
Practice address
3260 BLUME DR, SUITE 425, RICHMOND, CA 94806-5203
(510) 243-9987
(510) 243-9991
Mailing address
3260 BLUME DR, SUITE 425, RICHMOND, CA 94806-5203
(510) 243-9987
(510) 243-9991
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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