Grace Services, LLC
Registered Nurse, Psych/Mental Health in Johnson City, TN. Organization (NPI-2).
NPI number1013336627
StatusActive
Last updated in NPPESApr 10, 2014
Details
- NPI
- 1013336627
- Entity type
- Organization (NPI-2)
- Legal business name
- Grace Services, LLC
- Organization subpart
- No
- Enumeration date
- Apr 10, 2014
- Last updated
- Apr 10, 2014
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WP0808X | Registered Nurse, Psych/Mental Health | 11054 | TN | Yes |
Other names
- Grace Health Services (Doing Business As)
Practice location
2 Worth CirSuite 2
Johnson City, TN 37601-4306
Phone 423-283-4958 · Fax 423-283-7135
Mailing address
2 Worth CirSuite 2
Johnson City, TN 37601-4306
Phone 423-283-4958 · Fax 423-283-7135
Authorized official
Gordon E Coburn
Owner
4232834958
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