Organization
SOBER BY GRACE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRYCE E HUDNALL (DIRECTOR)
(817) 606-9580
Entity
Organization
Contact information
Practice address
2451 BOMAR AVE, FORT WORTH, TX 76103-2211
(817) 386-7584
Mailing address
1056 SAGEWOOD LN, SAGINAW, TX 76131-4805
(817) 606-9580
(817) 887-1347
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
67601
TX
324500000X
Substance Abuse Rehabilitation Facility
67601
TX
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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