Healthcare Provider Details

I. General information

NPI: 1871428656
Provider Name (Legal Business Name): GRACEBRIDGE COMMUNITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4251 AVIEMORE RUN
BURLINGTON NC
27215-9449
US

IV. Provider business mailing address

130 GOLDENROD CT
BURLINGTON NC
27215-7036
US

V. Phone/Fax

Practice location:
  • Phone: 336-684-7504
  • Fax:
Mailing address:
  • Phone: 336-639-0553
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSILYN MARIE GRIFFIS
Title or Position: CO-OWNER
Credential:
Phone: 336-684-7504