Organization
GRACEFUL LIVING HOME CARE AGENCY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILLIS COLE (CEO)
(317) 886-8810
Entity
Organization
Contact information
Practice address
5410 SAGEBRUSH AVE APT 5, INDIANAPOLIS, IN 46203-5795
(317) 886-8810
Mailing address
5410 SAGEBRUSH AVE APT 5, INDIANAPOLIS, IN 46203-5795
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
3747P1801X
Personal Care Attendant
—
—
374U00000X
Home Health Aide
Primary
—
—
376J00000X
Homemaker
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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