Provider Demographics
NPI:1841887890
Name:GRACEHOMECAREFL LIMITED LIABILITY COMPANY
Entity type:Organization
Organization Name:GRACEHOMECAREFL LIMITED LIABILITY COMPANY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHERILUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-888-9443
Mailing Address - Street 1:2100 45TH ST STE A4
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-2063
Mailing Address - Country:US
Mailing Address - Phone:561-888-9443
Mailing Address - Fax:561-320-0089
Practice Address - Street 1:2100 45TH ST STE A4
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2063
Practice Address - Country:US
Practice Address - Phone:561-888-9443
Practice Address - Fax:561-320-0089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty