Healthcare Provider Details

I. General information

NPI: 1225947963
Provider Name (Legal Business Name): GRACEFUL CARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/26/2026
Certification Date: 09/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1618 AZALEA DR
NORTH BRUNSWICK NJ
08902-5541
US

IV. Provider business mailing address

1618 AZALEA DR
NORTH BRUNSWICK NJ
08902-5541
US

V. Phone/Fax

Practice location:
  • Phone: 302-494-7810
  • Fax:
Mailing address:
  • Phone: 302-494-7810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. GLENNA MANSARAY
Title or Position: DIRECTOR
Credential:
Phone: 302-494-7810