Provider Demographics
NPI:1811793235
Name:GRACEFUL CARGIVERS SOLUTION, INC
Entity type:Organization
Organization Name:GRACEFUL CARGIVERS SOLUTION, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DODD
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARINE
Authorized Official - Middle Name:NTSONONG
Authorized Official - Last Name:AYAFOR
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:773-387-6476
Mailing Address - Street 1:4641 HARVEST AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTY TWP
Mailing Address - State:OH
Mailing Address - Zip Code:45011-2368
Mailing Address - Country:US
Mailing Address - Phone:773-387-6476
Mailing Address - Fax:
Practice Address - Street 1:4641 HARVEST AVE
Practice Address - Street 2:
Practice Address - City:LIBERTY TWP
Practice Address - State:OH
Practice Address - Zip Code:45011-2368
Practice Address - Country:US
Practice Address - Phone:773-387-6476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No253Z00000XAgenciesIn Home Supportive Care