Organization
GRACE LOVE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANAH NANKUNDA (CEO)
(702) 439-1631
Entity
Organization
Contact information
Practice address
970 E CORRALL ST, AVONDALE, AZ 85323-2757
(702) 439-1631
Mailing address
970 E CORRALL ST, AVONDALE, AZ 85323-2757
(702) 439-1631
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/13/2024
Last updated
03/13/2024
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