| NPI | 1508575895 |
|---|---|
| Other Name | GRACE COVENANT SERVICES, LLC |
| Entity Type | Organization |
| Authorized Contact | JENNIFER JOHNSON Administrator 662-580-0635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2022-12-20 |