Provider Demographics
NPI:1649976465
Name:GRACEFUL HOME CARE LLC
Entity type:Organization
Organization Name:GRACEFUL HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CALMESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-251-7245
Mailing Address - Street 1:1614 E MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-4056
Mailing Address - Country:US
Mailing Address - Phone:337-251-7245
Mailing Address - Fax:
Practice Address - Street 1:1614 E MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-4056
Practice Address - Country:US
Practice Address - Phone:337-251-7245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care