Provider Demographics
NPI:1417754060
Name:WINGS OF GRACE HOME CARE SERVICES LLC
Entity type:Organization
Organization Name:WINGS OF GRACE HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTATION
Authorized Official - Prefix:
Authorized Official - First Name:JERILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-862-0062
Mailing Address - Street 1:23719 96TH ST E
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-7481
Mailing Address - Country:US
Mailing Address - Phone:253-862-0062
Mailing Address - Fax:253-862-0596
Practice Address - Street 1:23719 96TH ST E
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-7481
Practice Address - Country:US
Practice Address - Phone:253-862-0062
Practice Address - Fax:253-862-0596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care