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Organization
SAVING GRACE BEHAVIOR HEALTH SERVICES
Active
Organization
SAVING GRACE BEHAVIOR HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. COLLINS YEBOA SIAKWAN MSW,LCAS, CCS, LCSWP (CHIEF EXECUTIVE OFFICER)
(252) 268-5433
Entity
Organization
Contact information
Practice address
1951A CAMBRIA DR, GREENVILLE, NC 27834-0094
(252) 353-7147
Mailing address
1951A CAMBRIA DR, GREENVILLE, NC 27834-0094
(252) 268-5433
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6111899
—
NC
Enumeration date
02/14/2009
Last updated
02/14/2009
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