# GRACE HEALTH AND WELLNESS FAMILY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184454795
- **Authorized official:** TIFFANIE M MCGUIRE NP (CRNP)
- **Authorized official phone:** (256) 203-5713

## Contact information

- **Practice address:** 443 PINE AVE SW, DECATUR, AL 35601-7631
- **Practice address phone:** (256) 203-5713
- **Practice address fax:** (256) 260-9544
- **Mailing address:** PO BOX 5393, DECATUR, AL 35601-0393
- **Mailing address phone:** (256) 203-5713

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |

## Other

- **Enumeration date:** 08/07/2024
- **Last updated:** 08/07/2024