Provider Demographics
NPI:1245976232
Name:GRACE FAMILY AND COMMUNITY COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:GRACE FAMILY AND COMMUNITY COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:DOW-NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:908-590-5810
Mailing Address - Street 1:90 E HALSEY RD STE 333
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3713
Mailing Address - Country:US
Mailing Address - Phone:908-590-5810
Mailing Address - Fax:
Practice Address - Street 1:90 E HALSEY RD STE 333
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3713
Practice Address - Country:US
Practice Address - Phone:908-590-5810
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive Care
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health