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General NPI Number Information
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NPI Number | 1518298827
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Entity Type | Organization
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Legal Business Name | GR&M NONPROFIT FOUNDATION
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 3431 QUAIL HIGH BLVD
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City | MORRISVILLE
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State | NC
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Zip | 27560-7016
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Country | US
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Telephone | 440-539-3184
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Fax |
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Provider Business Mailing Address
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Address Line | 3431 QUAIL HIGH BLVD
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City | MORRISVILLE
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State | NC
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Zip | 27560-7016
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Country | US
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Telephone | 440-539-3184
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | MS. MIA FELICE STUBBS
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Credential |
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Telephone | 440-539-3184
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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