GRACEFUL AGING HOME CARE INC. (NPI# 1053795732) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053795732 |
| Entity Type | Organization |
| Organization Name | GRACEFUL AGING HOME CARE INC. |
| Other Organization Name | AGE ADVANTAGE SENIOR CARE SERVICES |
| Practice Address |
228 N Lynnhaven Rd Suite 106 Virginia Beach VA 23452-7514 |
| Practice Telephone | 7573403315 |
| Practice Fax Number | 7573403317 |
| Mailing Telephone | 7573403315 |
| Mailing Fax Number | 7573403317 |
| Enumeration Date | 2015-07-13 |
| Last Update Date | 2015-07-13 |
| Authorized Official Name | VINCENT R. MEDINA (PRESIDENT) |
| Authorized Official Telephone | 7573403315 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253Z00000X | In Home Supportive Care | HCO-151016 | VA | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | MEDICAID API NUMBER FOR PERSONAL CARE | 0171722397 | 01 |
| VA | MEDICAID API NUMBER FOR RESPITE CARE | 0171721910 | 01 |
| Other Name | Type Code |
|---|---|
| Age Advantage Senior Care Services | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | Graceful Aging Home Care Inc. | 5504 Fair Oaks Drive, Virginia Beach, Virginia 23464 |
| Street Address |
228 N LYNNHAVEN RD SUITE 106 |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23452-7514 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487721064 | Tracy Sawyer | Chiropractor | 228 N Lynnhaven Rd, Suite 115, Virginia Beach, VA 23452-7514 | 2006-11-29 |
| 1497090633 | Ebony Williams Poindexter | Community Health Worker | 228 N Lynnhaven Rd, Suite 107, Virginia Beach, VA 23452-7514 | 2012-11-28 |
| 1780827808 | Angela Renae Jones | Psychologist | 228 N Lynnhaven Rd, Suite 107, Virginia Beach, VA 23452-7514 | 2009-04-20 |
| 1306089529 | Jfl Care II Inc | Psychologist | 228 N Lynnhaven Rd, Suite #107, Virginia Beach, VA 23452-7514 | 2009-04-17 |
| 1659514842 | Chenequa Tanee' Moulds | Psychologist | 228 N Lynnhaven Rd, Suite 107, Virginia Beach, VA 23452-7514 | 2009-04-17 |
| 1649417304 | Michelle Anne Booth | Chiropractor | 228 N Lynnhaven Rd, Suite 115, Virginia Beach, VA 23452-7514 | 2009-01-15 |
| 1023200573 | D E Cleckner Jr. Dds PC | Clinic/Center | 228 N Lynnhaven Rd, Suite 105, Virginia Beach, VA 23452-7514 | 2007-08-17 |
| 1659417749 | Tracy L M Sawyer | Chiropractor | 228 N Lynnhaven Rd, Suite 115, Virginia Beach, VA 23452-7514 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881208650 | Tracie Marie Romero | Counselor | 236 Mustag Trail Ste, Virginia Beach, VA 23452 | 2020-08-31 |
| 1346884400 | Asra R Javeed Dmd PC | Dentist | 4312 Holland Rd Ste 108, Virginia Beach, VA 23452 | 2019-11-01 |
| 1598313298 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 397 Little Neck Rd, Building 3400, Suite 107, Virginia Beach, VA 23452 | 2019-08-27 |
| 1205483229 | Brenna Dober | Behavior Technician | 380 Clevend Place, Virginia Beach, VA 23452 | 2019-08-23 |
| 1639652977 | Jessica Keefe | Psychologist | 642 Carriage Hill Road, Virginia Beach, VA 23452 | 2018-09-12 |
| 1316433709 | Circle of Life, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 3630 S Plaza Trl Ste 210a, Virginia Beach, VA 23452 | 2018-07-09 |
| 1992205165 | Jeremy Monsanto | Behavior Technician | 629 Phoenix Drive, Ste 150, Virginia Beach, VA 23452 | 2018-02-14 |
| 1174056014 | Samantha Brown | Behavior Technician | 780 Nnhaven Parkway, Suite 400, Virginia Beach, VA 23452 | 2017-04-07 |
| 1043757685 | Join1,llc | Home Health | 349 Southport Circle, Suite 106, Virginia Beach, VA 23452 | 2017-01-20 |
| 1720520620 | Renee Brush | Psychologist | 485 S Independence Blvd Ste 104, Virginia Beach, VA 23452 | 2016-11-08 |
| Find all providers in zip 23452 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518570860 | Prime Care Consultants LLC | In Home Supportive Care | 3707 Virginia Beach Blvd Ste 202, Virginia Beach, VA 23452-3412 | 2020-08-26 |
| 1285268516 | Len Renewed Hope LLC | In Home Supportive Care | 2476 Seven Kings Rd, Virginia Beach, VA 23456-7824 | 2020-02-25 |
| 1154969962 | Loving Care Svcs., Inc. | In Home Supportive Care | 921 Richland Dr, Virginia Beach, VA 23464-3926 | 2019-12-12 |
| 1437795945 | Commonwealth Counseling Agency LLC | In Home Supportive Care | 138 S Rosemont Rd Ste 208, Virginia Beach, VA 23452-4336 | 2019-11-19 |
| 1578114476 | Rahco Virginia Beach LLC. | In Home Supportive Care | 1300 Diamond Springs Rd Ste 301, Virginia Beach, VA 23455-3645 | 2019-09-23 |
| 1760941777 | Dembi Home Health Care LLC | In Home Supportive Care | 4264 Kenton Ln, Virginia Beach, VA 23456-1661 | 2019-03-19 |
| 1790226215 | B & R Supportive Living, LLC | In Home Supportive Care | 1119 Commonwealth Pl, Virginia Beach, VA 23464-4527 | 2017-03-16 |
| 1790137602 | Greater Heights Homecare Agency LLC | In Home Supportive Care | 5348 Summer Cres, Virginia Beach, VA 23462-1948 | 2016-07-05 |
| 1184094617 | Oval Health LLC | In Home Supportive Care | 5216 Winding Bank Rd, Virginia Beach, VA 23455-6810 | 2015-09-27 |
| 1770951493 | Compassionate Home Healthcare Services, LLC | In Home Supportive Care | 1637 Janke Rd, Virginia Beach, VA 23455-3419 | 2015-09-11 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23452 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.