Provider Demographics
NPI:1740141399
Name:ANGELS OF GRACE HOME HEALTH SERVICES
Entity type:Organization
Organization Name:ANGELS OF GRACE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:J
Authorized Official - Last Name:COKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:803-460-5516
Mailing Address - Street 1:2220 PEACH ORCHARD RD STE B
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29154-1112
Mailing Address - Country:US
Mailing Address - Phone:803-460-5516
Mailing Address - Fax:
Practice Address - Street 1:2220 PEACH ORCHARD RD STE B
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29154-1112
Practice Address - Country:US
Practice Address - Phone:803-460-5516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-22
Last Update Date:2025-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care