Organization
GRACEFUL LIVING HOME CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREE MONCHELLE QUEZADA RN (OWNER)
(910) 985-7163
Entity
Organization
Contact information
Practice address
5341 APRIL WIND DR, FUQUAY VARINA, NC 27526-9470
(704) 310-1196
Mailing address
5341 APRIL WIND DR, FUQUAY VARINA, NC 27526-9470
(704) 310-1196
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
12/27/2024
Last updated
12/27/2024
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