| A Space For Grace, Llc | |
|
215 Fidalgo Ave Ste 204a Kenai AK 99611-7776 | |
| (907) 252-8878 | |
| Not Available |
| Full Name | A Space For Grace, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 215 Fidalgo Ave Ste 204a, Kenai, Alaska |
| Authorized Official Name and Position | Alex Wingster (OWNER) |
| Authorized Official Contact | 9072528878 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| A Space For Grace, Llc 2560 Seine Ct Kenai AK 99611-8827 Ph: (907) 252-8878 | A Space For Grace, Llc 215 Fidalgo Ave Ste 204a Kenai AK 99611-7776 Ph: (907) 252-8878 |
| NPI Number | 1366130403 |
|---|---|
| Provider Enumeration Date | 04/26/2023 |
| Last Update Date | 04/26/2023 |
| Certification Date | 04/26/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366130403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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