Provider Demographics
NPI:1891535340
Name:AMAZING GRACE HOMECARE SERVICES LLC
Entity type:Organization
Organization Name:AMAZING GRACE HOMECARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:URE
Authorized Official - Middle Name:
Authorized Official - Last Name:WARIBOKO
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:713-443-6094
Mailing Address - Street 1:1020 SUGARDALE CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498-2760
Mailing Address - Country:US
Mailing Address - Phone:832-449-8153
Mailing Address - Fax:
Practice Address - Street 1:1020 SUGARDALE CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498-2760
Practice Address - Country:US
Practice Address - Phone:832-449-8153
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-30
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes177F00000XOther Service ProvidersLodging