| NPI | 1669938528 |
|---|---|
| Doing Business As | HOUSE OF GRACE |
| Entity Type | Organization |
| Authorized Contact | TAMMY TIDD Director 765-481-1570 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2019-02-15 |