Healthcare Provider Details

I. General information

NPI: 1144986803
Provider Name (Legal Business Name): SAVING GRACE BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2021
Last Update Date: 11/30/2023
Certification Date: 11/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 NEEDHAM ST STE 203
NEWTON MA
02464-1502
US

IV. Provider business mailing address

168 WOOD RD
SOUTH YARMOUTH MA
02664-4228
US

V. Phone/Fax

Practice location:
  • Phone: 508-292-6730
  • Fax:
Mailing address:
  • Phone: 508-292-6730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SHIANNE GRACE
Title or Position: OWNER
Credential:
Phone: 508-292-6730