MEDICARE: GRACEFUL 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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1477405439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEFUL HOME CARE SERVICES, LLC

Provider Business Mailing Address
First Line	:	2363 SHIMMERY LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-6001
Country	:	US
Telephone Number	:	516-738-1511
Fax Number	:

Provider Business Practice Location Address
First Line	:	2363 SHIMMERY LN
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-6001
Country	:	US
Telephone Number	:	516-738-1511
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RUSSHELL GORDON
Credential	:	CNA
Telephone Number	:	516-738-1511

Provider Enumeration Date	:	02/12/2026
Last Update Date	:	02/12/2026

Similar Medicare Providers

1649015306 — CARINA D ALVARADO ALVARADO
Practice Location Address:

2321 SHIMMERY LN
LANTANA, FL
33462-6001

Practice Phone: 561-667-7467
Practice Fax:

1437155751 — JEFFREY E LIANG M.D.
Practice Location Address:

6001 HARRIS PKWY
FORT WORTH, TX
76132-4103

Practice Phone: 817-370-6350
Practice Fax: 817-370-6401

1154379741 — DIAGNOSTIC HEALTH CENTERS OF TEXAS LIMITED PARTNERSHIP
Practice Location Address:

6001 HARRIS PKWY
FORT WORTH, TX
76132-4103

Practice Phone: 817-294-1131
Practice Fax: 817-294-3882

1174833222 — TOUCHSTONE IMAGING OF MESQUITE, LP
Practice Location Address:

6001 HARRIS PKWY
FORT WORTH, TX
76132-4103

Practice Phone: 817-294-1131
Practice Fax: 817-294-3882

1477808020 — DR. LEE BRANDON HARTMAN D.C.
Practice Location Address:

6001 HARRIS PKWY
FT WORTH, TX
76132-4103

Practice Phone: 817-370-6350
Practice Fax:

1104247634 — INTEGRATED SPINAL SOLUTIONS, PLLC
Practice Location Address:

6001 HARRIS PKWY
FORT WORTH, TX
76132-4103

Practice Phone: 817-768-3899
Practice Fax: 817-370-6401

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

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.