Healthcare Provider Details

I. General information

NPI: 1760312714
Provider Name (Legal Business Name): GRACEFUL HEARTS SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 NORTON AVE APT 7
SOUTH EASTON MA
02375-1221
US

IV. Provider business mailing address

165 NORTON AVE APT 7
SOUTH EASTON MA
02375-1221
US

V. Phone/Fax

Practice location:
  • Phone: 857-249-0366
  • Fax:
Mailing address:
  • Phone: 857-249-0366
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MS. ABIBATU VERONICA SAMANYA TAMU
Title or Position: CEO/FOUNDER
Credential: MHA
Phone: 857-249-0366