Organization
GRACEFUL COMPANION HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALIL DEVANTE GRAHAM (OWNER)
(843) 229-9364
Entity
Organization
Contact information
Practice address
411 MARTIN LUTHER KING AVE, KINGSTREE, SC 29556-4016
(843) 401-0141
(843) 401-0141
Mailing address
411 MARTIN LUTHER KING AVE, KINGSTREE, SC 29556-4016
(843) 401-0141
(843) 401-0141
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
10/03/2024
Last updated
10/07/2024
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