MEDICARE: GRACEFUL HEARTS 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	374U00000X	Home Health Aide
2	163WH0200X	Home Health Registered Nurse

General Provider Information

NPI Number	:	1760312714
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEFUL HEARTS SERVICES LLC

Provider Business Mailing Address
First Line	:	165 NORTON AVE APT 7
Second Line	:
City	:	SOUTH EASTON
State	:	MA
Zip	:	02375-1221
Country	:	US
Telephone Number	:	857-249-0366
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 NORTON AVE APT 7
Second Line	:
City	:	SOUTH EASTON
State	:	MA
Zip	:	02375-1221
Country	:	US
Telephone Number	:	857-249-0366
Fax Number	:

Authorized Official
Title or Position	:	CEO/FOUNDER
Name	:	MS. ABIBATU VERONICA SAMANYA TAMU
Credential	:	MHA
Telephone Number	:	857-249-0366

Provider Enumeration Date	:	05/21/2026
Last Update Date	:	05/21/2026

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Directions to “GRACEFUL HEARTS SERVICES LLC ” Practice Location

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