| NPI | 1003405978 |
|---|---|
| Doing Business As | GRACEWAY COUNSELING CENTER |
| Entity Type | Organization |
| Authorized Contact | MATTHEW MAYNARD Owner 304-691-0873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 251S00000X | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2024-09-05 |