Home Of Grace Nc Llc | |
2501 Lyon St Gastonia NC 28052-6251 | |
(757) 779-4593 | |
Not Available |
Full Name | Home Of Grace Nc Llc |
---|---|
Speciality | Community/behavioral Health |
Location | 2501 Lyon St, Gastonia, North Carolina |
Authorized Official Name and Position | Renea Church (MRS) |
Authorized Official Contact | 7577794593 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Home Of Grace Nc Llc 301 S Mcdowell St Ste 125-1745 Charlotte NC 28204-2623 Ph: (757) 779-4593 | Home Of Grace Nc Llc 2501 Lyon St Gastonia NC 28052-6251 Ph: (757) 779-4593 |
NPI Number | 1174369862 |
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Provider Enumeration Date | 07/02/2024 |
Last Update Date | 07/05/2024 |
Certification Date | 07/05/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1174369862 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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