Provider Demographics
NPI:1790460434
Name:IN-SYNC MENTAL HEALTH LLC
Entity Type:Organization
Organization Name:IN-SYNC MENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JAENELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRACE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:256-482-6922
Mailing Address - Street 1:600 BOULEVARD S SW STE 104
Mailing Address - Street 2:#1117
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802
Mailing Address - Country:US
Mailing Address - Phone:256-482-6922
Mailing Address - Fax:256-834-8182
Practice Address - Street 1:600 BOULEVARD S SW STE 104
Practice Address - Street 2:#1117
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802
Practice Address - Country:US
Practice Address - Phone:256-482-6922
Practice Address - Fax:256-834-8182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty