Provider Demographics
NPI:1730437997
Name:GRACEFUL HOME HEALTH CARE
Entity type:Organization
Organization Name:GRACEFUL HOME HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPN/OPERATOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:ADJO
Authorized Official - Last Name:TORKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:785-424-2785
Mailing Address - Street 1:409 N CRESTLINE DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-1663
Mailing Address - Country:US
Mailing Address - Phone:785-424-2785
Mailing Address - Fax:
Practice Address - Street 1:409 N CRESTLINE DR
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66049-1663
Practice Address - Country:US
Practice Address - Phone:785-424-2785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-20
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSA-023-020251E00000X, 253Z00000X, 385H00000X, 251J00000X
KS17D2042742291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No291U00000XLaboratoriesClinical Medical Laboratory