Organization
GRACEFUL LIVING RESIDENTIAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ETHIOPIA WORKU GEZAHAGN (EXECUTIVE DIRECTOR)
(615) 424-4507
Entity
Organization
Contact information
Practice address
5544 CRAFTWOOD DR, ANTIOCH, TN 37013-4882
(615) 424-4507
Mailing address
5544 CRAFTWOOD DR, ANTIOCH, TN 37013-4882
(615) 424-4507
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
05/12/2025
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