Provider Demographics
NPI:1942778220
Name:GRIT HEALTHCARE SOLUTIONS, LLC
Entity Type:Organization
Organization Name:GRIT HEALTHCARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-229-0172
Mailing Address - Street 1:3220 MISTLETOE WAY
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-1042
Mailing Address - Country:US
Mailing Address - Phone:434-229-0172
Mailing Address - Fax:757-282-5802
Practice Address - Street 1:3220 MISTLETOE WAY
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-1042
Practice Address - Country:US
Practice Address - Phone:434-229-0172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-05
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health