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Organization

MY GRANDPARENTS HOUSE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SOPHIA PRISCILLA PEART (OWNER)
(862) 334-9703
Entity
Organization

Contact information

Practice address
3284 LANDING VW, TAVARES, FL 32778-2035
(862) 334-9703
Mailing address
220 STRAIGHT ST APT 311, PATERSON, NJ 07501-1953

Taxonomy

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

Other

Enumeration date
02/16/2021
Last updated
02/16/2021
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