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General NPI Number Information
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NPI Number | 1417710369
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Entity Type | Organization
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Legal Business Name | GRACIOUS HOME CARE SERVICES, LLC
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Dates
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Enumeration Date | 02/02/2024
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 1305 WALDRIDGE CT
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City | GREENSBORO
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State | NC
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Zip | 27406
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Country | US
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Telephone | 313-444-5224
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Fax |
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Provider Business Mailing Address
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Address Line | 17410 MACK AVE
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City | GROSSE POINTE
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State | MI
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Zip | 48230-6228
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ASHLEY S DEMONIQUE
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Credential |
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Telephone | 336-880-9399
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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