Provider Demographics
NPI:1265256762
Name:AGING GRACEFULLY CARE HOMES LLC
Entity type:Organization
Organization Name:AGING GRACEFULLY CARE HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IRENE
Authorized Official - Middle Name:
Authorized Official - Last Name:PALAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:760-207-6488
Mailing Address - Street 1:1895 AVENIDA DEL ORO UNIT 6605
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92052-0306
Mailing Address - Country:US
Mailing Address - Phone:760-207-6488
Mailing Address - Fax:760-444-6464
Practice Address - Street 1:3218 MIRA MESA AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-4302
Practice Address - Country:US
Practice Address - Phone:760-206-3398
Practice Address - Fax:760-444-6464
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility