Provider Demographics
NPI:1962269712
Name:GRACEFUL COMFORT HOME CARE SERVICE, LLC
Entity type:Organization
Organization Name:GRACEFUL COMFORT HOME CARE SERVICE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-258-0468
Mailing Address - Street 1:770 GARDNER RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:38635-8376
Mailing Address - Country:US
Mailing Address - Phone:901-258-0468
Mailing Address - Fax:
Practice Address - Street 1:4780 RIVERDALE RD STE 16
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38141-8509
Practice Address - Country:US
Practice Address - Phone:901-258-0468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care