Provider Demographics
NPI:1699440941
Name:GENTLE AND GRACIOUS HOME CARE LLC
Entity type:Organization
Organization Name:GENTLE AND GRACIOUS HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT CARE
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:443-707-9226
Mailing Address - Street 1:1003 MULFORD CT UNIT 1582
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-0299
Mailing Address - Country:US
Mailing Address - Phone:443-707-9226
Mailing Address - Fax:
Practice Address - Street 1:4704 SLEEPY FALLS RUN
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-5139
Practice Address - Country:US
Practice Address - Phone:443-707-9226
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care