Amazing Grace Personal Care Service, Inc

Organization Active NPI In Home Supportive Care Agency · Rio Rancho, NM

NPI 1164638565 · NPPES record last updated Sep 27, 2024

Key facts

NPI
1164638565
Entity type
Organization (NPI type 2)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Legal business name
AMAZING GRACE PERSONAL CARE SERVICE, INC
Practice address
4131 Barbara Loop SE # 2D
Rio Rancho, NM 87124-1362
Phone
(505) 796-4900
Fax
(505) 896-4513
NPI assigned
May 15, 2007
Organization subpart
No

Authorized official

Name
Tom Crider, M. DIV
Title
Owner
Phone
(505) 796-4900

National Provider Directory

Locations

1613 S Second St
Gallup, NM 87301
Phone (505) 863-5898

4131 Barbara Loop SE
#2D
Rio Rancho, NM 87124
Phone (505) 796-4900

4131 Barbara Loop SE
#D2
Rio Rancho, NM 87124

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Yes
Personal Care Attendant
Group: 193200000X MULTI-SPECIALTY GROUP
3747P1801X

Addresses

Primary practice location

4131 Barbara Loop SE # 2D
Rio Rancho, NM 87124-1362

Mailing address

4131 Barbara Loop SE # 2D
Rio Rancho, NM 87124-1362
Phone (505) 863-5898

Other practice location 1

1613 South 2nd Street
Gallup, NM 57301-5816
Phone (505) 863-5898

Other identifiers

IdentifierTypeStateIssuer
62985736MedicaidNM

Other providers in Rio Rancho, NM

All providers in Rio Rancho, NM · In Home Supportive Care Agency in New Mexico

Sources for this page

Verify at the official NPI Registry.