Provider Demographics
NPI:1134628258
Name:GRACE BEHAVIORAL HEALTH
Entity type:Organization
Organization Name:GRACE BEHAVIORAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:908-652-5311
Mailing Address - Street 1:1A BROOKFIELD GLEN DR
Mailing Address - Street 2:
Mailing Address - City:BELVIDERE
Mailing Address - State:NJ
Mailing Address - Zip Code:07823-2854
Mailing Address - Country:US
Mailing Address - Phone:908-652-5311
Mailing Address - Fax:908-320-4311
Practice Address - Street 1:1A BROOKFIELD GLEN DR
Practice Address - Street 2:
Practice Address - City:BELVIDERE
Practice Address - State:NJ
Practice Address - Zip Code:07823-2854
Practice Address - Country:US
Practice Address - Phone:908-652-5311
Practice Address - Fax:908-320-4311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-04
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty