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General NPI Number Information
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NPI Number | 1033959879
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Entity Type | Organization
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Legal Business Name | GRACED 2 CARE, ARF INC.
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Dates
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Enumeration Date | 05/29/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 14285 FAA BLVD APT 4213
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City | FORT WORTH
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State | TX
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Zip | 76155-2660
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Country | US
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Telephone | 682-521-0085
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Fax |
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Provider Business Mailing Address
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Address Line | 13337 SOUTH ST # 226
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City | CERRITOS
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State | CA
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Zip | 90703-7308
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Country | US
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Telephone | 682-521-0085
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. STEPHANEE S HARBERR
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Credential |
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Telephone | 682-521-0085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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