Provider Demographics
NPI:1063226983
Name:GRACE OF GOD AND COMPANY LLC
Entity type:Organization
Organization Name:GRACE OF GOD AND COMPANY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AUGUSTINA
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:SADOH
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:408-561-2202
Mailing Address - Street 1:8840 IMRAY WAY
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95624-5222
Mailing Address - Country:US
Mailing Address - Phone:408-561-2202
Mailing Address - Fax:
Practice Address - Street 1:8840 IMRAY WAY
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95624-5222
Practice Address - Country:US
Practice Address - Phone:408-561-2202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251J00000XAgenciesNursing Care
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty