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General NPI Number Information
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NPI Number | 1205749587
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Entity Type | Organization
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Legal Business Name | GRACIOUS HEARTS WELLNESS AND RECOVERY
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Dates
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Enumeration Date | 09/25/2026
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Last Update Date | 09/25/2026
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Provider Practice Location Address
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Address Line | 3548 CROWDERS VIEW DR
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City | GASTONIA
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State | NC
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Zip | 28052-5718
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Country | US
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Telephone | 704-810-1053
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Fax |
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Provider Business Mailing Address
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Address Line | 3548 CROWDERS VIEW DR
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City | GASTONIA
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State | NC
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Zip | 28052-5718
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Country | US
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Telephone | 704-810-1053
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MONIQUE HORTON
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Credential |
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Telephone | 716-603-2202
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State |
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