Healthcare Provider Details

I. General information

NPI: 1508715434
Provider Name (Legal Business Name): GRACEFUL PATHWAYS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 S PIKE E STE 1A
SUMTER SC
29150-2131
US

IV. Provider business mailing address

188 S PIKE E STE 1A
SUMTER SC
29150-2131
US

V. Phone/Fax

Practice location:
  • Phone: 803-836-0663
  • Fax: 803-836-0867
Mailing address:
  • Phone: 803-836-0663
  • Fax: 803-836-0867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. GWENTASHA NMN MIMS
Title or Position: ADMINISTRATOR/EXECUTIVE DIRECTOR
Credential: MIMS
Phone: 803-848-7868