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General NPI Number Information
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NPI Number | 1598654980
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Entity Type | Organization
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Legal Business Name | RETURN TO GRACE
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 111 W 5TH ST
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City | TYLER
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State | TX
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Zip | 75701-4006
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Country | US
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Telephone | 979-422-8185
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Fax |
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Provider Business Mailing Address
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Address Line | 3604 DONNA DR
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City | TYLER
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State | TX
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Zip | 75702-6507
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Country | US
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Telephone | 979-422-8185
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JENNIFER WHITE
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Credential |
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Telephone | 979-422-8185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #11
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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