Provider Demographics
NPI:1528948361
Name:GRACEFULLY LIVING HOME HEALTH, LLC
Entity type:Organization
Organization Name:GRACEFULLY LIVING HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:757-325-0649
Mailing Address - Street 1:4020 CHERRYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-3342
Mailing Address - Country:US
Mailing Address - Phone:757-325-0649
Mailing Address - Fax:757-325-0649
Practice Address - Street 1:4020 CHERRYWOOD CT
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23321-3342
Practice Address - Country:US
Practice Address - Phone:757-325-0649
Practice Address - Fax:757-325-0649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty