Organization
AMAZING GRACE HEALTHCARE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BINETTE FORZONG FONGE (DIRECTOR)
(202) 390-7313
Entity
Organization
Contact information
Practice address
2306 BRIGHTSEAT RD APT 5, LANDOVER, MD 20785-3550
(202) 390-7313
Mailing address
2306 BRIGHTSEAT RD APT 5, LANDOVER, MD 20785-3550
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
11/24/2020
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