Provider Demographics
NPI:1235671249
Name:GRACIOUS HOME CARE
Entity Type:Organization
Organization Name:GRACIOUS HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-465-7071
Mailing Address - Street 1:1216 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:MI
Mailing Address - Zip Code:49224-2018
Mailing Address - Country:US
Mailing Address - Phone:517-465-7071
Mailing Address - Fax:
Practice Address - Street 1:1216 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:MI
Practice Address - Zip Code:49224-2018
Practice Address - Country:US
Practice Address - Phone:517-465-7071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-08
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health