Provider Demographics
NPI:1134095573
Name:GODS ONLY CHOICE CITY OF REFUGE INC
Entity type:Organization
Organization Name:GODS ONLY CHOICE CITY OF REFUGE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLETTE
Authorized Official - Middle Name:DANYELLE
Authorized Official - Last Name:ONLY-GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-265-4447
Mailing Address - Street 1:3342 S 257TH DR # 663607
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-1832
Mailing Address - Country:US
Mailing Address - Phone:480-788-4557
Mailing Address - Fax:
Practice Address - Street 1:8910 W MONROE ST
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-6440
Practice Address - Country:US
Practice Address - Phone:480-788-4557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-14
Last Update Date:2025-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness