# DEI GRACIA HEALTHCARE LLC

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

## Provider details

- **NPI number:** 1235018987
- **Authorized official:** NATHALIE ROSINE KORI NKENLIFACK MANHENKEU APRN (MANAGER)
- **Authorized official phone:** (217) 819-7328

## Contact information

- **Practice address:** 909 N CUNNINGHAM AVE, URBANA, IL 61802-1744
- **Practice address phone:** (217) 607-8110
- **Mailing address:** 1409 OGELTHORPE AVE, URBANA, IL 61802-4749
- **Mailing address phone:** (217) 819-7328

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 08/28/2025
- **Last updated:** 05/13/2026