Grace Therapy LLC
Clinic/Center, Mental Health (Including Community Mental Health Center) in Nettleton, MS. Organization (NPI-2).
NPI number1174472005
StatusActive
Last updated in NPPESJan 23, 2026
Details
- NPI
- 1174472005
- Entity type
- Organization (NPI-2)
- Legal business name
- Grace Therapy LLC
- Organization subpart
- No
- Enumeration date
- Jan 23, 2026
- Certification date
- Jan 23, 2026
- Last updated
- Jan 23, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0801X | Clinic/Center, Mental Health (Including Community Mental Health Center) | – | – | Yes |
Practice location
172 Young AveNettleton, MS 38858-6010
Phone 662-591-1030
Mailing address
432 Road 1203Nettleton, MS 38858-8283
Phone 662-591-1030 · Fax 662-591-1030
Authorized official
Deborra Cassandra Rikard
Owner
6625911030
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