Organization
GRACE HEALTHCARE SERVICES INC
Active
Other names
McDougle Personal Care Home Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CYNTHIA E MCDOUGLE (CEO)
(229) 269-8880
Entity
Organization
Contact information
Practice address
1010 SLATER STREET, VALDOSTA, GA 31601
(229) 469-4052
(229) 588-4039
Mailing address
1010 SLATER STREET, VALDOSTA, GA 31601
(229) 469-4052
(229) 588-4039
Taxonomy
Speciality
Code
Description
License number
State
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
372083530A
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
092-01-106-1
PERSONAL CARE PERMIT NO
GA
01
—
372083530A
PROVIDER ID NUMBER
GA
Enumeration date
04/02/2010
Last updated
01/10/2019
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