| Essential Grace Therapy, Llc | |
|
12930 James St Ste 130 Holland MI 49424-8324 | |
| (616) 510-4330 | |
| Not Available |
| Full Name | Essential Grace Therapy, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 12930 James St Ste 130, Holland, Michigan |
| Authorized Official Name and Position | Elizabeth Delreal (CEO) |
| Authorized Official Contact | 6165104330 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Essential Grace Therapy, Llc 12930 James St Ste 130 Holland MI 49424-8324 Ph: () - | Essential Grace Therapy, Llc 12930 James St Ste 130 Holland MI 49424-8324 Ph: (616) 510-4330 |
| NPI Number | 1487405403 |
|---|---|
| Provider Enumeration Date | 03/28/2024 |
| Last Update Date | 03/28/2024 |
| Certification Date | 03/28/2024 |
| Medicare PECOS PAC ID | 3678005931 |
|---|---|
| Medicare Enrollment ID | O20241011002835 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487405403 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Elizabeth Marie Delreal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578092078 PECOS PAC ID: 7618395112 Enrollment ID: I20200915003632 |
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