NPIMap

Organization Active NPI

Amazing Grace Pca LLC

  • In Home Supportive Care Agency
  • Fayetteville, NC
National Provider Identifier
1083450498
Registry record updated Jul 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
AMAZING GRACE PCA LLC
Practice address
182 Ellerslie Dr
Fayetteville, NC 28303-5917
Phone
(907) 342-5608
NPI assigned
Jul 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2024

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

Authorized official

Name
Dr. Delphenia M Lodiong, PHD
Title
Administrator
Phone
(907) 342-5608

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Home Health Agency 251E00000X
Nursing Care Agency 251J00000X
Community/Behavioral Health Agency 251S00000X
In Home Supportive Care Agency 253Z00000X Primary
Child Mental Illness Respite Care 385HR2055X
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X
Child Physical Disabilities Respite Care 385HR2065X

Addresses

Primary practice location

182 Ellerslie Dr
Fayetteville, NC 28303-5917

Mailing address

182 Ellerslie Dr
Fayetteville, NC 28303-5917
Phone (907) 342-5608

Other names 1

  • Amazing Grace Personal Care Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1720051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720051200000",
    "number": "1083450498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 ELLERSLIE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035917",
            "telephone_number": "907-342-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 ELLERSLIE DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283035917",
            "telephone_number": "907-342-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMAZING GRACE PCA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-04",
        "last_updated": "2024-07-04",
        "certification_date": "2024-07-04",
        "status": "A",
        "authorized_official_last_name": "LODIONG",
        "authorized_official_first_name": "DELPHENIA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "907-342-5608",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Amazing Grace Personal Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2024; 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.