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Graceful Living Residential Care, LLC

In Home Supportive Care in Nashville, TN. Organization (NPI-2).

NPI number1063257699
StatusActive
Last updated in NPPESMay 14, 2026

Details

NPI
1063257699
Entity type
Organization (NPI-2)
Legal business name
Graceful Living Residential Care, LLC
Organization subpart
No
Enumeration date
Jun 26, 2024
Certification date
May 14, 2026
Last updated
May 14, 2026

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
253Z00000X In Home Supportive Care––Yes

Practice location

325 Plus Park Blvd Ste 101f
Nashville, TN 37217-1022

Phone 615-424-4507

Mailing address

325 Plus Park Blvd Ste 101f
Nashville, TN 37217-1022

Phone 615-424-4507

Authorized official

Ethiopia Worku Gezahagn
Executive Director
6154244507

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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