Healthcare Provider Details

I. General information

NPI: 1659207587
Provider Name (Legal Business Name): THE MERCY GRACE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 DARWICK RD
WINSTON SALEM NC
27127-8711
US

IV. Provider business mailing address

1951 DARWICK RD
WINSTON SALEM NC
27127-8711
US

V. Phone/Fax

Practice location:
  • Phone: 336-995-3670
  • Fax:
Mailing address:
  • Phone: 336-995-3670
  • 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: MICHELLE WILLIAMS
Title or Position: FOUNDER AND EXECUTIVE DIRECTOR
Credential:
Phone: 336-995-3670