Provider Demographics
NPI:1326802745
Name:FULL OF GRACE CONSULTING SERVICES LLC
Entity Type:Organization
Organization Name:FULL OF GRACE CONSULTING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMAKA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPUNONU
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:215-868-4433
Mailing Address - Street 1:100 HORIZON CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08691-1910
Mailing Address - Country:US
Mailing Address - Phone:856-925-9330
Mailing Address - Fax:856-298-4011
Practice Address - Street 1:100 HORIZON CENTER BLVD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08691-1910
Practice Address - Country:US
Practice Address - Phone:856-925-9330
Practice Address - Fax:856-298-4011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty