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General NPI Number Information
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NPI Number | 1033042254
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Entity Type | Organization
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Legal Business Name | RESTORATION BY GRACE
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Dates
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Enumeration Date | 06/06/2026
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Last Update Date | 06/06/2026
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Provider Practice Location Address
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Address Line | 6511 SW 10TH ST
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068-2630
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Country | US
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Telephone | 754-715-9476
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Fax |
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Provider Business Mailing Address
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Address Line | 6511 SW 10TH ST
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City | NORTH LAUDERDALE
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State | FL
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Zip | 33068-2630
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Country | US
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Telephone | 754-715-9476
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Fax |
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Authorized Official
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Title or Position | COMPLIANCE DIRECTOR
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Name | SHIRLEY CELCIS
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Credential | MSW
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Telephone | 702-237-7519
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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