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Organization
GRACE HEALTH & REHAB OF GRENADA, LLC
Active
Organization
GRACE HEALTH & REHAB OF GRENADA, LLC
Active
Parent organization
COVENANT DOVE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT DOVE, LLC
Authorized official
ADRIENNE J MURPHY (VICE PRESIDENT)
(901) 937-7994
Entity
Organization
Contact information
Practice address
1966 HILL DR, GRENADA, MS 38901-5047
(662) 226-2442
(662) 226-9567
Mailing address
1966 HILL DR, GRENADA, MS 38901-5047
(662) 226-2442
(662) 226-9567
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09238334
—
MS
Enumeration date
12/08/2009
Last updated
04/12/2012
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