Provider Demographics
NPI:1982470159
Name:AGING GRACEFULLY RESIDENCE CARE, LLC
Entity Type:Organization
Organization Name:AGING GRACEFULLY RESIDENCE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMMANUELLA
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-587-6476
Mailing Address - Street 1:1983 SKIDMORE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4616
Mailing Address - Country:US
Mailing Address - Phone:407-587-6476
Mailing Address - Fax:
Practice Address - Street 1:1983 SKIDMORE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-4616
Practice Address - Country:US
Practice Address - Phone:407-587-6476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-29
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty