Healthcare Provider Details

I. General information

NPI: 1144156803
Provider Name (Legal Business Name): GRACEFUL CARE & WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4395 WATOGA DR
LIBERTY TWP OH
45011-2746
US

IV. Provider business mailing address

4395 WATOGA DR
LIBERTY TWP OH
45011-2746
US

V. Phone/Fax

Practice location:
  • Phone: 513-822-8822
  • Fax:
Mailing address:
  • Phone: 513-822-8822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL

VIII. Authorized Official

Name: KINGSLEY SIKOT
Title or Position: CEO
Credential:
Phone: 602-802-9511