Healthcare Provider Details

I. General information

NPI: 1184269144
Provider Name (Legal Business Name): GRA THERAPY SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 SHERIDAN ST STE 400
HOLLYWOOD FL
33021-3435
US

IV. Provider business mailing address

3418 OTTAWA LN
HOLLYWOOD FL
33026-4616
US

V. Phone/Fax

Practice location:
  • Phone: 954-737-3957
  • Fax: 954-281-4525
Mailing address:
  • Phone: 754-216-9883
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GREGORY REID ADELSTEIN
Title or Position: PRESIDENT
Credential: PSY.D, LMHC
Phone: 754-216-9883