GRACE RIDEOUT

RUSSELLVILLE, AR
NPI1649651852
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2015-06-12
Last Update Date2015-06-12
Business Address
-- GRACE RIDEOUT CIT
400 LAKE FRONT DR
RUSSELLVILLE, AR 72802-2206
Phone number: 479-968-7086
Mailing Address
-- GRACE RIDEOUT CIT
PO BOX 1463
RUSSELLVILLE, AR 72811-1463
Phone number: 479-968-7086