# GRACEFULLY EXTENDED LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Gracefully Extended LLC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528792199
- **Authorized official:** MS. ARYELLE ROBERTSON (CEO)
- **Authorized official phone:** (561) 506-5348

## Contact information

- **Practice address:** 3203 CONWAY RD STE 200-C, ORLANDO, FL 32812-7303
- **Practice address phone:** (877) 977-1433
- **Mailing address:** 3203 CONWAY RD STE 200-C, ORLANDO, FL 32812-7303
- **Mailing address phone:** (877) 977-1433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/11/2022
- **Last updated:** 07/12/2022