Healthcare Provider Details

I. General information

NPI: 1336904473
Provider Name (Legal Business Name): GRACEFUL DAY PERSONAL HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2024
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 S FALCON ST APT C
ANAHEIM CA
92804-4568
US

IV. Provider business mailing address

824 S FALCON ST APT C
ANAHEIM CA
92804-4568
US

V. Phone/Fax

Practice location:
  • Phone: 954-494-3146
  • Fax:
Mailing address:
  • Phone: 954-494-3146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: ROSELINE BRANDA ANDRE
Title or Position: OWNER
Credential:
Phone: 954-494-3146