Supreme Grace and Favor Home Care LLC

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Legal business name

SUPREME GRACE AND FAVOR HOME CARE LLC

Practice address

847 Declaration Dr
Pittsboro, IN 46167-8834

Phone

(317) 454-6582

Fax

(317) 641-2213

NPI assigned

Oct 22, 2025

Last updated

Oct 22, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Grace OlanusiNPI 1902773195

Title

Manager

Phone

(317) 454-6582

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Grace Modolani Olanusi

  • Personal Care Attendant
  • Pittsboro, IN
  • NPI 1902773195

  Single Specialty

  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761091200000",
    "number": "1073480083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "847 DECLARATION DR",
            "city": "PITTSBORO",
            "state": "IN",
            "postal_code": "461678834",
            "telephone_number": "317-454-6582",
            "fax_number": "317-641-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "847 DECLARATION DR",
            "city": "PITTSBORO",
            "state": "IN",
            "postal_code": "461678834",
            "telephone_number": "317-454-6582",
            "fax_number": "317-641-2213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME GRACE AND FAVOR HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A",
        "authorized_official_last_name": "OLANUSI",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "317-454-6582"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Personal Care Attendant in Pittsboro, IN
• Providers in Pittsboro, IN by specialty
• Personal Care Attendant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.