Provider Demographics
NPI:1548461445
Name:GRACEFUL LIVING LLC
Entity type:Organization
Organization Name:GRACEFUL LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIANA
Authorized Official - Middle Name:IIOSEN
Authorized Official - Last Name:ULOFOSHIO
Authorized Official - Suffix:
Authorized Official - Credentials:CARE PROVIDER
Authorized Official - Phone:907-952-9918
Mailing Address - Street 1:6600 E 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99504-1734
Mailing Address - Country:US
Mailing Address - Phone:907-338-3135
Mailing Address - Fax:
Practice Address - Street 1:6600 E 11TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99504-1734
Practice Address - Country:US
Practice Address - Phone:907-338-3135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-29
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK000299311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home