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1649651852
GRACE RIDEOUT
RUSSELLVILLE, AR
NPI
1649651852
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2015-06-12
Last Update Date
2015-06-12
Business Address
-- GRACE RIDEOUT CIT
400 LAKE FRONT DR
RUSSELLVILLE, AR 72802-2206
Phone number: 479-968-7086
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Mailing Address
-- GRACE RIDEOUT CIT
PO BOX 1463
RUSSELLVILLE, AR 72811-1463
Phone number: 479-968-7086
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