Organization
HIS GRACE AND MERCY HOME CARE LLC
Active
Other names
chiro home care
Organization subpart
No
Provider details
NPI number
Authorized official
NIKIA ROSEBORO (OWNER)
(980) 819-7540
Entity
Organization
Contact information
Practice address
3125 EASTWAY DR STE 213, CHARLOTTE, NC 28205-5643
(980) 819-7540
Mailing address
3125 EASTWAY DR STE 213, CHARLOTTE, NC 28205-5643
(980) 819-7540
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210776
—
NC
Enumeration date
10/12/2021
Last updated
10/12/2021
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