MEDICARE: GRACE HOPE TREATMENT & RECOVERY CENTERS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1083272579
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACE HOPE TREATMENT & RECOVERY CENTERS, INC.

Provider Business Mailing Address
First Line	:	100 N CITRUS ST STE 408
Second Line	:
City	:	WEST COVINA
State	:	CA
Zip	:	91791-1684
Country	:	US
Telephone Number	:	510-333-0060
Fax Number	:	626-339-6894

Provider Business Practice Location Address
First Line	:	7446 LIME AVE
Second Line	:
City	:	FONTANA
State	:	CA
Zip	:	92336-3173
Country	:	US
Telephone Number	:	510-333-0060
Fax Number	:	626-339-6894

Authorized Official
Title or Position	:	CEO
Name	:	MS. GRACE UWADIALE
Credential	:	CPA
Telephone Number	:	510-333-0060

Provider Enumeration Date	:	05/30/2019
Last Update Date	:	06/07/2026

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