| House Of Grace Llc | |
|
401 Camden Rd Huntington WV 25704-2708 | |
| (606) 939-8486 | |
| Not Available |
| Full Name | House Of Grace Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 401 Camden Rd, Huntington, West Virginia |
| Authorized Official Name and Position | Rose Onyinyechi Uradu (MEDICAL DIRECTOR) |
| Authorized Official Contact | 6069398486 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| House Of Grace Llc 401 Camden Rd Huntington WV 25704-2708 Ph: (606) 939-8486 | House Of Grace Llc 401 Camden Rd Huntington WV 25704-2708 Ph: (606) 939-8486 |
| NPI Number | 1609333830 |
|---|---|
| Provider Enumeration Date | 02/25/2019 |
| Last Update Date | 02/25/2019 |
| Medicare PECOS PAC ID | 5597165357 |
|---|---|
| Medicare Enrollment ID | O20210616000050 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609333830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | (* (Not Available)) | Secondary |
| Provider Name | Rose Onyinyechi Uradu |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1326050634 PECOS PAC ID: 3173521499 Enrollment ID: I20210616000091 |
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