Grace Covenant Homes LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

GRACE COVENANT HOMES LLC

Practice address

3409 Shoreline Dr
Harker Heights, TX 76548-8120

Phone

(248) 252-6739

Fax

(254) 393-0457

NPI assigned

Feb 8, 2019

Organization subpart

No

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

Authorized official

Name

Ms. Icilda G Edwards

Title

Owner/Manager

Phone

(248) 252-6739

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1549584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549584000000",
    "number": "1730644253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3409 SHORELINE DR",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765488120",
            "telephone_number": "248-252-6739",
            "fax_number": "254-393-0457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3409 SHORELINE DR",
            "city": "HARKER HEIGHTS",
            "state": "TX",
            "postal_code": "765488120",
            "telephone_number": "248-252-6739",
            "fax_number": "254-393-0457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE COVENANT HOMES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-08",
        "last_updated": "2019-02-08",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "ICILDA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "248-252-6739",
        "authorized_official_name_prefix": "Ms."
    },
    "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 Harker Heights, TX
• Providers in Harker Heights, TX by specialty
• In Home Supportive Care Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2019; 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.