# ALLURING GRACE

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

## Provider details

- **NPI number:** 1700324613
- **Authorized official:** VICTORIA SHUNTRELL JORDAN PCSSS (COMMUNITY SUPPORT SPECIALIST)
- **Authorized official phone:** (601) 529-0910

## Contact information

- **Practice address:** 2501 W 7TH ST, APT 806, HATTIESBURG, MS 39401-3244
- **Practice address phone:** (601) 529-0910
- **Mailing address:** 2501 W 7TH ST, APT 806, HATTIESBURG, MS 39401-3244
- **Mailing address phone:** (601) 529-0910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | — | NULL | Yes |

## Other

- **Enumeration date:** 02/10/2017
- **Last updated:** 02/10/2017