Organization Active NPI

Gracestar Home Health LLC

  • In Home Supportive Care Agency
  • Woodbridge, VA
National Provider Identifier
1326898164
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
GRACESTAR HOME HEALTH LLC
Practice address
17300 River Ridge Blvd Ste 201
Woodbridge, VA 22191-5168
Phone
(571) 221-4656
NPI assigned
Mar 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Abena Owusu-Sekyere
Title
Ceo
Phone
(571) 221-4656

Specialties & licenses 13

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WH0200X
Developmentally Disabled Services Day Training Agency 251C00000X
Home Health Agency 251E00000X
Community Based Hospice Care Agency 251G00000X
Nursing Care Agency 251J00000X
In Home Supportive Care Agency 253Z00000X Primary
Non-emergency Medical Transport (VAN) 343900000X
Private Vehicle 347C00000X
Personal Care AttendantGroup: 193200000X MULTI-SPECIALTY GROUP 3747P1801X
Home Health AideGroup: 193200000X MULTI-SPECIALTY GROUP 374U00000X
Respite Care 385H00000X
Respite Care Camp 385HR2050X
Child Physical Disabilities Respite Care 385HR2065X

Addresses

Primary practice location

17300 River Ridge Blvd Ste 201
Woodbridge, VA 22191-5168

Mailing address

17300 River Ridge Blvd Ste 201
Woodbridge, VA 22191-5168
Phone (571) 221-4656

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737936000000",
    "number": "1326898164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 RIVER RIDGE BLVD STE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221915168",
            "telephone_number": "571-221-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 RIVER RIDGE BLVD STE 201",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221915168",
            "telephone_number": "571-221-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACESTAR HOME HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A",
        "authorized_official_last_name": "OWUSU-SEKYERE",
        "authorized_official_first_name": "ABENA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "571-221-4656"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2050X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care Camp",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.