Provider Demographics
NPI:1518298827
Name:GR&M NONPROFIT FOUNDATION
Entity Type:Organization
Organization Name:GR&M NONPROFIT FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:MIA
Authorized Official - Middle Name:FELICE
Authorized Official - Last Name:STUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-539-3184
Mailing Address - Street 1:3431 QUAIL HIGH BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7016
Mailing Address - Country:US
Mailing Address - Phone:440-539-3184
Mailing Address - Fax:
Practice Address - Street 1:3431 QUAIL HIGH BLVD
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-7016
Practice Address - Country:US
Practice Address - Phone:440-539-3184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness