Provider Demographics
NPI:1982382909
Name:GRATEFUL CARE SERVICES LLC
Entity Type:Organization
Organization Name:GRATEFUL CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:REDONDO EIDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-822-5283
Mailing Address - Street 1:2780 BINGHAMPTON LN
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30044-2774
Mailing Address - Country:US
Mailing Address - Phone:470-469-9729
Mailing Address - Fax:
Practice Address - Street 1:2780 BINGHAMPTON LN
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30044-2774
Practice Address - Country:US
Practice Address - Phone:704-699-7294
Practice Address - Fax:770-674-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health