Provider Demographics
NPI:1902583040
Name:GRACE & MERCY HOME CARE LLC
Entity Type:Organization
Organization Name:GRACE & MERCY HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TARONDA
Authorized Official - Middle Name:MCSHELIA
Authorized Official - Last Name:GILLIARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-696-4993
Mailing Address - Street 1:PO BOX 1482
Mailing Address - Street 2:
Mailing Address - City:HOLLY HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29059-1482
Mailing Address - Country:US
Mailing Address - Phone:803-496-1120
Mailing Address - Fax:803-496-1120
Practice Address - Street 1:734B GILWAY STREET
Practice Address - Street 2:
Practice Address - City:HOLLY HILL
Practice Address - State:SC
Practice Address - Zip Code:29059
Practice Address - Country:US
Practice Address - Phone:803-496-1120
Practice Address - Fax:803-496-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care