# GRACEFUL GUARDIANS HEALTH CARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487469870
- **Authorized official:** LATISHA DAVIS (CEO)
- **Authorized official phone:** (229) 942-0642

## Contact information

- **Practice address:** 107 KNOLLWOOD DR APT C3, AMERICUS, GA 31709-5337
- **Practice address phone:** (229) 942-0642
- **Mailing address:** 107 KNOLLWOOD DR APT C3, AMERICUS, GA 31709-5337
- **Mailing address phone:** (229) 942-0642

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 343900000X | Non-emergency Medical Transport (VAN) | — | NULL | — |
| 347C00000X | Private Vehicle | — | NULL | — |
| 385H00000X | Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 02/11/2025
- **Last updated:** 02/11/2025