His Grace Home Care LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

HIS GRACE HOME CARE LLC

Practice address

5202 Fairington Village Dr
Lithonia, GA 30038-1371

Phone

(678) 362-3094

NPI assigned

Oct 12, 2021

Organization subpart

No

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

Authorized official

Name

Adenike Emosu

Title

Owner

Phone

(678) 362-3094

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1114689775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1402",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300581000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 FAIRINGTON VILLAGE DR",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300381371",
            "telephone_number": "678-362-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HIS GRACE HOME CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "EMOSU",
        "authorized_official_first_name": "ADENIKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-362-3094"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Lithonia, GA
• Providers in Lithonia, GA by specialty
• In Home Supportive Care Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.