Gracious Care Agency LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

GRACIOUS CARE AGENCY LLC

Practice address

1175 Main St
Clinton, MA 01510-1130

Phone

(978) 365-3323

Fax

(978) 365-3328

NPI assigned

Nov 27, 2013

Last updated

May 29, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Pierre Omeler

Title

Ceo

Phone

(978) 365-3323

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1679903793. Details of each certification follow.

• CCN 227603 Home health agency · Active · Details

Home health agency certification: CCN 227603

Legal name

GRACIOUS CARE AGENCY LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Mar 24, 2015

Last certification

Apr 19, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Incorporated

May 16, 2012 in MA

Enrollment address

1175 Main St
Clinton, MA 01510-1130
HHA Branch

Listed as

Gracious Care Agency LLCCCN 227603 · All quality measures

Ownership

Proprietary

Certified

Mar 24, 2015

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Gracious Care Agency LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gracious Care Agency LLC

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1598013542
  NPD tax ID

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401321600000",
    "number": "1679903793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 MAIN ST",
            "city": "CLINTON",
            "state": "MA",
            "postal_code": "015101130",
            "telephone_number": "978-365-3323",
            "fax_number": "978-365-3328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 MAIN ST",
            "city": "CLINTON",
            "state": "MA",
            "postal_code": "015101130",
            "telephone_number": "978-365-3323",
            "fax_number": "978-365-3328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACIOUS CARE AGENCY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2014-05-29",
        "status": "A",
        "authorized_official_last_name": "OMELER",
        "authorized_official_first_name": "PIERRE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-365-3323",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marc Gagnier, MD
• Brett Gannon, LCSW
• Pamela Gaw
• Michael Arthur Gillis, PHARMD
• Scott H. Gonzalez, M.D.
• Kaitlin T Guillemette, RDN, LDN
• Marylyn Ha-Trinh
• Donald James Hager III, L.M.H.C
• Julie Person Hailey, MS, PT, LAT, C
• Nicole Hartnett, FNP

• Home Health Agency in Clinton, MA
• Providers in Clinton, MA by specialty
• Home Health Agency in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.