MEDICARE: GRACE ALPHA FOCUSED CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	323P00000X	Psychiatric Residential Treatment Facility

General Provider Information

NPI Number	:	1790620235
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE ALPHA FOCUSED CARE LLC

Provider Business Mailing Address
First Line	:	29517 SALEM FIELDS DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1572
Country	:	US
Telephone Number	:	832-585-1195
Fax Number	:	832-699-3260

Provider Business Practice Location Address
First Line	:	29517 SALEM FIELDS DR
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77386-1572
Country	:	US
Telephone Number	:	832-585-1195
Fax Number	:	832-699-3260

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	DR. NGOZI LADOKUN
Credential	:	FNP-C
Telephone Number	:	339-965-4978

Provider Enumeration Date	:	04/21/2026
Last Update Date	:	04/21/2026

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