Provider Demographics
NPI:1740648724
Name:GRACEFUL CARING
Entity type:Organization
Organization Name:GRACEFUL CARING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WAVELET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-978-7315
Mailing Address - Street 1:26834 SHOREGRASS DR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33544
Mailing Address - Country:US
Mailing Address - Phone:410-978-7315
Mailing Address - Fax:410-978-7315
Practice Address - Street 1:26834 SHOREGRASS DR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33544
Practice Address - Country:US
Practice Address - Phone:410-978-7315
Practice Address - Fax:410-978-7315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-04
Last Update Date:2016-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization