Provider Demographics
NPI:1427669258
Name:GRACEFULLY TREASURED HOMECARE, INC
Entity type:Organization
Organization Name:GRACEFULLY TREASURED HOMECARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HENDRIETTA
Authorized Official - Middle Name:W
Authorized Official - Last Name:CUMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-451-2541
Mailing Address - Street 1:PO BOX 141406
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32614-1406
Mailing Address - Country:US
Mailing Address - Phone:352-451-2541
Mailing Address - Fax:
Practice Address - Street 1:6113 NW 23RD TER
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32653-1980
Practice Address - Country:US
Practice Address - Phone:352-451-2541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care