MEDICARE: GRACEHOMECAREFL LIMITED LIABILITY COMPANY

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

General Provider Information

NPI Number	:	1841887890
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEHOMECAREFL LIMITED LIABILITY COMPANY

Provider Business Mailing Address
First Line	:	2100 45TH ST STE A4
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2063
Country	:	US
Telephone Number	:	561-888-9443
Fax Number	:	561-320-0089

Provider Business Practice Location Address
First Line	:	2100 45TH ST STE A4
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2063
Country	:	US
Telephone Number	:	561-888-9443
Fax Number	:	561-320-0089

Authorized Official
Title or Position	:	OWNER
Name	:	FADELINE CHERILUS
Credential	:
Telephone Number	:	561-888-9443

Provider Enumeration Date	:	12/23/2020
Last Update Date	:	09/11/2024

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