Healthcare Provider Details

I. General information

NPI: 1588585368
Provider Name (Legal Business Name): GRACIOUS CARE HOME SERVICES,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6168 WILLIAM J HARDY DR
CALEDONIA MI
49316-7136
US

IV. Provider business mailing address

6168 WILLIAM J HARDY DR
CALEDONIA MI
49316-7136
US

V. Phone/Fax

Practice location:
  • Phone: 616-318-6146
  • Fax:
Mailing address:
  • Phone: 616-318-6146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: STACIA BROWN
Title or Position: OWNER
Credential:
Phone: 616-318-6146