MEDICARE: GRACIOUS NURSING CARE

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	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1306160528
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACIOUS NURSING CARE

Provider Business Mailing Address
First Line	:	3410 MANDERES PL
Second Line	:
City	:	SPRINGDALE
State	:	MD
Zip	:	20774-2526
Country	:	US
Telephone Number	:	301-773-4363
Fax Number	:

Provider Business Practice Location Address
First Line	:	3410 MANDERES PL
Second Line	:
City	:	SPRINGDALE
State	:	MD
Zip	:	20774-2526
Country	:	US
Telephone Number	:	301-773-4363
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	OLAYINKA FOLAYAN
Credential	:
Telephone Number	:	301-773-4363

Provider Enumeration Date	:	03/16/2010
Last Update Date	:	03/17/2010

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Directions to “GRACIOUS NURSING CARE ” Practice Location

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