Healthcare Provider Details

I. General information

NPI: 1528635794
Provider Name (Legal Business Name): GRACIOUS HOME ADULT DAY HEALTH CARE CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2021
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 RAY AVE
BURLINGTON MA
01803-4721
US

IV. Provider business mailing address

2 RAY AVE
BURLINGTON MA
01803-4721
US

V. Phone/Fax

Practice location:
  • Phone: 781-698-5627
  • Fax: 781-362-0360
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LEI JING
Title or Position: MANAGER
Credential:
Phone: 781-698-5627