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Organization
MARYS HOUSE OF RESTORATION, INC.
Active
Organization
MARYS HOUSE OF RESTORATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CARLA M GRANTT (CHEIF EXECUTIVE OFFICER)
(501) 744-8799
Entity
Organization
Contact information
Practice address
9320 CLOVERHILL RD, LITTLE ROCK, AR 72205-4617
(501) 744-8799
(501) 747-1149
Mailing address
9320 CLOVERHILL RD, LITTLE ROCK, AR 72205-4617
(501) 744-8799
(501) 747-1149
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
405300000X
Prevention Professional
—
—
Other
Enumeration date
10/26/2022
Last updated
10/26/2022
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