Healthcare Provider Details

I. General information

NPI: 1255217543
Provider Name (Legal Business Name): GRACEEN HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2025
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8735 DUNWOODY PL STE 12695
ATLANTA GA
30350-2995
US

IV. Provider business mailing address

8735 DUNWOODY PL # 12695
ATLANTA GA
30350-2995
US

V. Phone/Fax

Practice location:
  • Phone: 727-432-0159
  • Fax:
Mailing address:
  • Phone: 727-432-0159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAWN HARRIS
Title or Position: OWNER/ADMINISTRATOR
Credential: RN
Phone: 727-432-0159