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Organization
GRAY MATTERS ALLIANCE LLC
Active
Organization
GRAY MATTERS ALLIANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI SPRAUL (PRESIDENT)
(314) 266-2678
Entity
Organization
Contact information
Practice address
119 S MAIN ST, SAINT CHARLES, MO 63301-2802
(314) 322-3875
Mailing address
119 S MAIN ST, SAINT CHARLES, MO 63301-2802
(314) 266-2678
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
06/07/2019
Last updated
04/24/2024
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