| Amazing Grace Center Inc | |
|
802 Clare Ave Portsmouth OH 45662 | |
| (740) 876-8449 | |
| Not Available |
| Full Name | Amazing Grace Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 802 Clare Ave, Portsmouth, Ohio |
| Authorized Official Name and Position | Rose Onyinyechi Uradu (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6063934632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amazing Grace Center Inc 802 Clare Ave Portsmouth OH 45662 Ph: (740) 876-8449 | Amazing Grace Center Inc 802 Clare Ave Portsmouth OH 45662 Ph: (740) 876-8449 |
| NPI Number | 1205188588 |
|---|---|
| Provider Enumeration Date | 10/10/2012 |
| Last Update Date | 10/04/2022 |
| Certification Date | 10/04/2022 |
| Medicare PECOS PAC ID | 7416187711 |
|---|---|
| Medicare Enrollment ID | O20140306001440 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205188588 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 13303 (Ohio) | Secondary |
| 261QM2800X | Clinic/center - Methadone | (* (Not Available)) | Primary |
| Provider Name | Rose Onyinyechi Uradu |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1326050634 PECOS PAC ID: 3173521499 Enrollment ID: I20061121000533 |
| Provider Name | Andrea Uradu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1467742502 PECOS PAC ID: 4587924931 Enrollment ID: I20190624001039 |
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