Provider Demographics
NPI:1790523959
Name:GRACEFUL AGING HOME CARE
Entity type:Organization
Organization Name:GRACEFUL AGING HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-522-8035
Mailing Address - Street 1:8888 KEYSTONE XING STE 1300
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-4600
Mailing Address - Country:US
Mailing Address - Phone:317-522-8035
Mailing Address - Fax:
Practice Address - Street 1:8888 KEYSTONE XING STE 1300
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-4600
Practice Address - Country:US
Practice Address - Phone:317-522-8035
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care