Provider Demographics
NPI:1588934111
Name:GRACIOUS FAMILY HOMECARE SERVICES, LLC
Entity type:Organization
Organization Name:GRACIOUS FAMILY HOMECARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROSELINE
Authorized Official - Middle Name:QUEH
Authorized Official - Last Name:SARNOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-813-2778
Mailing Address - Street 1:114 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-2710
Mailing Address - Country:US
Mailing Address - Phone:610-813-2778
Mailing Address - Fax:484-288-8821
Practice Address - Street 1:203 E LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-3407
Practice Address - Country:US
Practice Address - Phone:610-813-2778
Practice Address - Fax:484-288-8821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-12
Last Update Date:2012-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA21853601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health