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General NPI Number Information
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NPI Number | 1588456537
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Entity Type | Organization
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Legal Business Name | GRACEFUL AID LLC
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Dates
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Enumeration Date | 05/17/2025
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Last Update Date | 05/26/2025
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Provider Practice Location Address
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Address Line | 829 W MLK BLVD STE 241
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City | TAMPA
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State | FL
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Zip | 33603-3301
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Country | US
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Telephone | 352-262-8124
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 891303
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City | TAMPA
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State | FL
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Zip | 33689-1101
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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 | OWNER
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Name | EDWARD LYNN CASON III
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Credential |
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Telephone | 352-262-8124
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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