Provider Demographics
NPI:1588537260
Name:GRACIA SERVICES LL
Entity type:Organization
Organization Name:GRACIA SERVICES LL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TITILOLA
Authorized Official - Middle Name:FUNBI
Authorized Official - Last Name:AYENI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-713-2036
Mailing Address - Street 1:4324 BEDROCK CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-5641
Mailing Address - Country:US
Mailing Address - Phone:443-713-2036
Mailing Address - Fax:
Practice Address - Street 1:4324 BEDROCK CIR APT 202
Practice Address - Street 2:
Practice Address - City:NOTTINGHAM
Practice Address - State:MD
Practice Address - Zip Code:21236-5641
Practice Address - Country:US
Practice Address - Phone:443-713-2036
Practice Address - Fax:443-713-2036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-27
Last Update Date:2025-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health