MEDICARE: GRACIENT HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1144175480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACIENT HOMECARE LLC

Provider Business Mailing Address
First Line	:	4134 AMBER LEIGH WAY DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-2358
Country	:	US
Telephone Number	:	412-999-1132
Fax Number	:

Provider Business Practice Location Address
First Line	:	4134 AMBER LEIGH WAY DR
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28269-2358
Country	:	US
Telephone Number	:	412-999-1132
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AGENCY DIRECTOR
Name	:	MRS. JEANETTE JORDAN MEACHEM
Credential	:
Telephone Number	:	412-999-1132

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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