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General NPI Number Information
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NPI Number | 1427921261
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Entity Type | Organization
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Legal Business Name | CHRISTIAN GRACE MINISTRIES
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Dates
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Enumeration Date | 09/26/2025
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 2701 W VERNON AVE
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City | LOS ANGELES
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State | CA
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Zip | 90008-3931
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Country | US
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Telephone | 800-355-4615
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Fax |
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Provider Business Mailing Address
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Address Line | 1575 WESTWOOD BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90024-5620
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Country | US
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Telephone | 800-355-4615
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Fax |
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Authorized Official
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Title or Position | CEO/EXECUTIVE DIRECTOR
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Name | MR. LAWRENCE FITZGERALD FLOYD
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Credential | MPSS
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Telephone | 626-417-6993
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number |
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License Number State |
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