Provider Demographics
NPI:1598785917
Name:MERCY N GRACE INC
Entity Type:Organization
Organization Name:MERCY N GRACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KEHINDE
Authorized Official - Middle Name:DUPE
Authorized Official - Last Name:OGUNBUNMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-536-5770
Mailing Address - Street 1:PO BOX 34653
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23234-0653
Mailing Address - Country:US
Mailing Address - Phone:804-536-5770
Mailing Address - Fax:804-861-0172
Practice Address - Street 1:6618 IRONGATE DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23234
Practice Address - Country:US
Practice Address - Phone:804-279-0736
Practice Address - Fax:804-562-5810
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities