| NPI | 1396345351 |
|---|---|
| Former Legal Business Name | SPACE FOR GRACE, LLC |
| Entity Type | Organization |
| Authorized Contact | RENEE P LEWIS Owner 443-889-2569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-11-11 |