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General NPI Number Information
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NPI Number | 1497679195
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Entity Type | Organization
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Legal Business Name | GRACEFUL LIVING ALF AND MEMORY CARE
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 700 BEVILLE RD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-5924
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Country | US
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Telephone | 389-333-9699
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Fax | 389-333-9697
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Provider Business Mailing Address
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Address Line | 700 BEVILLE RD
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City | DAYTONA BEACH
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State | FL
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Zip | 32114-5924
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Country | US
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Telephone | 389-333-9699
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Fax | 389-333-9697
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | FANFAN SALIBA
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Credential |
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Telephone | 407-948-2434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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