MEDICARE: GRACEFUL LIFE HOME CARE SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1013874684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEFUL LIFE HOME CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	265 N LABURNUM AVE APT 3
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-3134
Country	:	US
Telephone Number	:	646-894-8646
Fax Number	:

Provider Business Practice Location Address
First Line	:	265 N LABURNUM AVE APT 3
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23223-3134
Country	:	US
Telephone Number	:	646-894-8646
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. ELVIN BRATTEN
Credential	:
Telephone Number	:	646-894-8646

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/07/2026

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Directions to “GRACEFUL LIFE HOME CARE SERVICES LLC ” Practice Location

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