Organization
GRACEFUL AGING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDITH SANDRA MUGISHA (PARTNER)
(224) 340-2365
Entity
Organization
Contact information
Practice address
1200 WESTPORT RDG, CRYSTAL LAKE, IL 60014-8989
(847) 226-0189
Mailing address
1200 WESTPORT RDG, CRYSTAL LAKE, IL 60014-8989
(847) 226-0189
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
05/27/2024
Last updated
05/27/2024
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