Provider Demographics
NPI:1689410839
Name:SUNSHINE GRACE PRIVATE CARE LLC
Entity type:Organization
Organization Name:SUNSHINE GRACE PRIVATE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANDRIA
Authorized Official - Middle Name:DIONNE
Authorized Official - Last Name:DRAPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-980-7321
Mailing Address - Street 1:765 CASTLEBROOKE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-2663
Mailing Address - Country:US
Mailing Address - Phone:404-980-7321
Mailing Address - Fax:
Practice Address - Street 1:765 CASTLEBROOKE DR
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30045-2663
Practice Address - Country:US
Practice Address - Phone:404-980-7321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care