MEDICARE: GRATEFUL BLESSINGS HOME CARE, 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

General Provider Information

NPI Number	:	1841990595
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRATEFUL BLESSINGS HOME CARE, LLC

Provider Business Mailing Address
First Line	:	6545 MARKET AVE N STE 100
Second Line	:
City	:	CANTON
State	:	OH
Zip	:	44721-2430
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3149 RIVER GLEN DR
Second Line	:
City	:	AUSTINBURG
State	:	OH
Zip	:	44010-9761
Country	:	US
Telephone Number	:	216-399-0991
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. CANDACE REED
Credential	:	RN
Telephone Number	:	216-399-0991

Provider Enumeration Date	:	03/09/2023
Last Update Date	:	04/04/2023

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