Organization
AMAZING GRACE PCA, LLC
Active
Other names
Amazing Grace Personal Care Service
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DELPHENIA MONTGOMERY LODIONG MBA (DIRECTOR)
(504) 261-7602
Entity
Organization
Contact information
Practice address
7240 CROWDER BLVD, SUITE 203, NEW ORLEANS, LA 70127-1922
(504) 309-8190
(504) 309-8196
Mailing address
413 QUEEN ANNE DR, SLIDELL, LA 70460-8439
(504) 261-7602
(504) 248-5302
Taxonomy
Speciality
Code
Description
License number
State
251G00000X
Community Based Hospice Care Agency
2203782320
LA
253Z00000X
In Home Supportive Care Agency
Primary
2203782320
LA
253Z00000X
In Home Supportive Care Agency
HC0007481
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026042
—
LA
05
—
1031305
—
LA
Enumeration date
04/27/2015
Last updated
04/27/2015
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