Organization
GRACEFULLY AGING LLC
Active
Parent organization
GRACEFULLY AGING LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRACEFULLY AGING LLC
Authorized official
NAKIA STARKER (MANAGER)
(407) 844-5840
Entity
Organization
Contact information
Practice address
1837 LOCHSHYRE LOOP, OCOEE, FL 34761-9160
(407) 744-9043
Mailing address
1837 LOCHSHYRE LOOP, OCOEE, FL 34761-9160
(407) 744-9043
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578032967
—
FL
Enumeration date
02/06/2019
Last updated
06/02/2021
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