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General NPI Number Information
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NPI Number | 1255703112
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Entity Type | Organization
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Legal Business Name | GRACIOUS SERVICES INC.
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Dates
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Enumeration Date | 10/30/2015
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 208 LENOX AVE SUITE 353
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City | WESTFIELD
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State | NJ
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Zip | 07090-5120
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Country | US
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Telephone | 908-759-8266
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Fax |
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Provider Business Mailing Address
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Address Line | 208 LENOX AVE SUITE 353
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City | WESTFIELD
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State | NJ
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Zip | 07090-5120
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Country | US
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Telephone | 908-759-8266
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. BAMIDELE A BADMUS
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Credential |
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Telephone | 908-759-8266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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