Healthcare Provider Details

I. General information

NPI: 1427985290
Provider Name (Legal Business Name): GRACE WAY LIVING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2026
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

332 LOWLAND DAIRY RD
MOUNT HOLLY NC
28120-9433
US

IV. Provider business mailing address

332 LOWLAND DAIRY RD
MOUNT HOLLY NC
28120-9433
US

V. Phone/Fax

Practice location:
  • Phone: 980-280-3606
  • Fax:
Mailing address:
  • Phone: 980-280-3606
  • 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: LAKIETA HOOD
Title or Position: OWNER/CEO
Credential:
Phone: 704-674-6274