Provider Demographics
NPI:1811754328
Name:GRACEFUL BEGINNINGS LLC
Entity type:Organization
Organization Name:GRACEFUL BEGINNINGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:GERALDA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILUS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:732-407-6396
Mailing Address - Street 1:76 WHITESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-5115
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:76 WHITESVILLE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-5115
Practice Address - Country:US
Practice Address - Phone:848-285-9830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-01
Last Update Date:2024-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health