Provider Demographics
NPI:1578368775
Name:GRACEFUL CARE AGENCY, INC
Entity type:Organization
Organization Name:GRACEFUL CARE AGENCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AUJEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMMAMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-227-2075
Mailing Address - Street 1:2434 BRATTON AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0418
Mailing Address - Country:US
Mailing Address - Phone:248-227-2075
Mailing Address - Fax:
Practice Address - Street 1:2434 BRATTON AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0418
Practice Address - Country:US
Practice Address - Phone:248-227-2075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health