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General NPI Number Information
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NPI Number | 1881542710
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Entity Type | Organization
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Legal Business Name | NEW GRACE WELLNESS, LLC
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 2208 SAINT ANDREW ST
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City | TARBORO
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State | NC
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Zip | 27886-2119
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Country | US
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Telephone | 252-289-3778
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Fax |
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Provider Business Mailing Address
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Address Line | 2208 SAINT ANDREW ST
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City | TARBORO
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State | NC
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Zip | 27886-2119
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Country | US
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Telephone | 252-289-3778
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ALEXIS PEGUES
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Credential | QMHP, CSAC
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Telephone | 252-289-3751
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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