Provider Demographics
NPI:1811133838
Name:GRACIOUS INTERNATIONAL INCORPORATED
Entity type:Organization
Organization Name:GRACIOUS INTERNATIONAL INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:AJUNWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:513-290-4254
Mailing Address - Street 1:260 NORTHLAND BLVD
Mailing Address - Street 2:SUITE 333
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-4917
Mailing Address - Country:US
Mailing Address - Phone:513-290-4254
Mailing Address - Fax:
Practice Address - Street 1:260 NORTHLAND BLVD
Practice Address - Street 2:SUITE 333
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45246-4917
Practice Address - Country:US
Practice Address - Phone:513-290-4254
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies