Provider Demographics
NPI:1487829073
Name:GRACE CARE INC.
Entity Type:Organization
Organization Name:GRACE CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROWLAND
Authorized Official - Middle Name:NGOZI
Authorized Official - Last Name:ACHUKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-484-4055
Mailing Address - Street 1:1318 RAMSEY ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301-4474
Mailing Address - Country:US
Mailing Address - Phone:910-484-4055
Mailing Address - Fax:910-486-4404
Practice Address - Street 1:1318 RAMSEY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-4474
Practice Address - Country:US
Practice Address - Phone:910-484-4055
Practice Address - Fax:910-486-4404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health