Provider Demographics
NPI:1588375679
Name:GRACIOUS HOME HEALTH & HOSPICE
Entity type:Organization
Organization Name:GRACIOUS HOME HEALTH & HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUNJIRI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:316-369-0968
Mailing Address - Street 1:11310 E 21ST ST N # G590
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-3578
Mailing Address - Country:US
Mailing Address - Phone:316-369-0968
Mailing Address - Fax:
Practice Address - Street 1:11310 E 21ST ST N # G590
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-3578
Practice Address - Country:US
Practice Address - Phone:316-369-0968
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based