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General NPI Number Information
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NPI Number | 1548533862
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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 | 02/16/2012
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 28 WINCHESTER CIR
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City | MONROE
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State | LA
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Zip | 71203-6625
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Country | US
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Telephone | 318-547-3909
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Fax |
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Provider Business Mailing Address
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Address Line | 28 WINCHESTER CIR
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City | MONROE
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State | LA
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Zip | 71203-6625
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Country | US
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Telephone | 318-547-3909
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ROYMELLE MASON
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Credential | RN.,BSN
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Telephone | 318-547-3909
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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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