# GRACE BEHAVIORAL HEALTH SERVICES

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

## Provider details

- **NPI number:** 1437766375
- **Authorized official:** OMEZIE MOLOKWU APN (PRESIDENT)
- **Authorized official phone:** (908) 417-0632

## Contact information

- **Practice address:** 1140 BURNT TAVERN RD STE 1A, BRICK, NJ 08724-1496
- **Practice address phone:** (908) 417-0632
- **Mailing address:** PO BOX 46, LAKEHURST, NJ 08733-0046
- **Mailing address phone:** (908) 417-0632

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/24/2020
- **Last updated:** 08/29/2023