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General NPI Number Information
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NPI Number | 1982901245
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Entity Type | Organization
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Legal Business Name | DAILY GRACE, LLC
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Dates
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Enumeration Date | 02/23/2011
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Last Update Date | 02/23/2011
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Provider Practice Location Address
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Address Line | 8255 HULL STREET RD
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City | RICHMOND
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State | VA
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Zip | 23235-6413
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Country | US
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Telephone | 804-399-9042
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Fax | 804-527-2025
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Provider Business Mailing Address
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Address Line | PO BOX 3382
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City | GLEN ALLEN
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State | VA
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Zip | 23058-3382
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Country | US
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Telephone | 804-399-9042
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Fax | 804-527-2025
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Authorized Official
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Title or Position | EXECUITVE DIRECTOR/OWNER
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Name | MS. SHARON LATIMORE TAHA
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Credential | CPHT
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Telephone | 804-399-9042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1392
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License Number State | VA
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