Healthcare Provider Details

I. General information

NPI: 1871145441
Provider Name (Legal Business Name): GRACEFUL CARE HOME HEALTH SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 E DAILY DR STE 224
CAMARILLO CA
93010-5840
US

IV. Provider business mailing address

601 E DAILY DR STE 224
CAMARILLO CA
93010-5840
US

V. Phone/Fax

Practice location:
  • Phone: 805-388-8217
  • Fax: 805-309-5188
Mailing address:
  • Phone: 805-388-8217
  • Fax: 805-309-5188

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: LADY AVEGAIL VELASCO
Title or Position: CEO
Credential:
Phone: 805-509-1878