Provider Demographics
NPI:1669858460
Name:SAVIN GRACE, LLC
Entity Type:Organization
Organization Name:SAVIN GRACE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-561-3111
Mailing Address - Street 1:111 N 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-3933
Mailing Address - Country:US
Mailing Address - Phone:919-205-1299
Mailing Address - Fax:866-230-4856
Practice Address - Street 1:3400 DUVENECK DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-8931
Practice Address - Country:US
Practice Address - Phone:919-561-3111
Practice Address - Fax:866-230-4856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health