Organization
GRACIOUS CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDY ZHAO (MANAGER)
(909) 994-6204
Entity
Organization
Contact information
Practice address
12515 HUDSON RIVER DR, EASTVALE, CA 91752-4327
(909) 994-6204
(951) 427-1047
Mailing address
12515 HUDSON RIVER DR, EASTVALE, CA 91752-4327
(909) 994-6204
(951) 427-1047
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
177F00000X
Lodging Provider
—
—
251T00000X
PACE Provider Organization
—
—
251V00000X
Voluntary or Charitable Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
311Z00000X
Custodial Care Facility
—
—
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
331880740
CCLD
CA
Enumeration date
12/19/2025
Last updated
12/19/2025
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