Provider Demographics
NPI:1447065123
Name:GRACE THERAPY LLC
Entity type:Organization
Organization Name:GRACE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RAUN
Authorized Official - Middle Name:D
Authorized Official - Last Name:SKYRM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-256-0533
Mailing Address - Street 1:3109 W LIBERTY AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15216-2403
Mailing Address - Country:US
Mailing Address - Phone:330-256-0533
Mailing Address - Fax:330-595-4727
Practice Address - Street 1:3109 W LIBERTY AVE STE 105
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15216-2403
Practice Address - Country:US
Practice Address - Phone:330-256-0533
Practice Address - Fax:330-595-4727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty