# GRACIOUSLY CLEAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cancer treatment and counseling
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619718236
- **Authorized official:** MADISON CHERRY (ADMINISTRATION)
- **Authorized official phone:** (706) 619-0448

## Contact information

- **Practice address:** 3407 JULIA AVE, AUGUSTA, GA 30906-4811
- **Practice address phone:** (706) 619-0449
- **Mailing address:** 3407 JULIA AVE, AUGUSTA, GA 30906-4811
- **Mailing address phone:** (706) 619-0449

## Taxonomy

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

## Other

- **Enumeration date:** 06/06/2024
- **Last updated:** 06/06/2024