| Grace Behavioral Health Services | |
|
1140 Burnt Tavern Rd Ste 1a Brick NJ 08724-1496 | |
| (908) 417-0632 | |
| Not Available |
| Full Name | Grace Behavioral Health Services |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1140 Burnt Tavern Rd Ste 1a, Brick, New Jersey |
| Authorized Official Name and Position | Omezie Molokwu (PRESIDENT) |
| Authorized Official Contact | 9084170632 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Behavioral Health Services Po Box 46 Lakehurst NJ 08733-0046 Ph: (908) 417-0632 | Grace Behavioral Health Services 1140 Burnt Tavern Rd Ste 1a Brick NJ 08724-1496 Ph: (908) 417-0632 |
| NPI Number | 1437766375 |
|---|---|
| Provider Enumeration Date | 09/24/2020 |
| Last Update Date | 08/29/2023 |
| Certification Date | 08/29/2023 |
| Medicare PECOS PAC ID | 9931513223 |
|---|---|
| Medicare Enrollment ID | O20210127003101 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437766375 | NPI | - | NPPES |
| Provider Name | Omezie A Molokwu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093322935 PECOS PAC ID: 5294149589 Enrollment ID: I20210127003259 |
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