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Organization

GRACEAGE CARES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ERAQUISA NESBY (OWNER)
(662) 274-9477
Entity
Organization

Contact information

Practice address
6000 POPLAR AVE, MEMPHIS, TN 38119-3981
(901) 690-5013
(662) 504-4234
Mailing address
201 POLO RUN CV, BYHALIA, MS 38611-7505
(901) 659-7242

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
311ZA0620X
Adult Care Home Facility
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
04/12/2024
Last updated
09/08/2025
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