MEDICARE: GRACEFUL CARE HOME HEALTH 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	:	1871145441
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACEFUL CARE HOME HEALTH SERVICES, LLC

Provider Business Mailing Address
First Line	:	601 E DAILY DR STE 224
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-5840
Country	:	US
Telephone Number	:	805-388-8217
Fax Number	:	805-309-5188

Provider Business Practice Location Address
First Line	:	601 E DAILY DR STE 224
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93010-5840
Country	:	US
Telephone Number	:	805-388-8217
Fax Number	:	805-309-5188

Authorized Official
Title or Position	:	CEO
Name	:	LADY AVEGAIL VELASCO
Credential	:
Telephone Number	:	805-509-1878

Provider Enumeration Date	:	07/12/2019
Last Update Date	:	12/10/2025

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