Provider Demographics
NPI:1932932886
Name:GRACE TO GRACE BEHAVIORAL HEALTH LLC
Entity type:Organization
Organization Name:GRACE TO GRACE BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOHNITA
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCGEE SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LISW
Authorized Official - Phone:216-798-6658
Mailing Address - Street 1:341 GREENVALE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2308
Mailing Address - Country:US
Mailing Address - Phone:216-798-6658
Mailing Address - Fax:
Practice Address - Street 1:341 GREENVALE RD
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-2308
Practice Address - Country:US
Practice Address - Phone:216-798-6658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-24
Last Update Date:2024-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty