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Organization

GRACIOUS SOUL HOME CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS NYAMAH KEYMAH II CNA (CNA)
(701) 989-8872
Entity
Organization

Contact information

Practice address
4719 NORTHBAY DR SE, MANDAN, ND 58554-4787
(701) 527-5178
Mailing address
4719 NORTHBAY DR SE, MANDAN, ND 58554-4787
(701) 527-5178

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
251G00000X
Community Based Hospice Care Agency
251S00000X
Community/Behavioral Health Agency
253Z00000X
In Home Supportive Care Agency
372600000X
Adult Companion
374U00000X
Home Health Aide
376K00000X
Nurse's Aide

Other

Enumeration date
01/11/2024
Last updated
01/11/2024
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