Organization
GRACE YOUTH HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAYNICO THREAT (CO-OWNER)
(901) 930-3486
Entity
Organization
Contact information
Practice address
155 OAK HOLLOW DR, OAKLAND, TN 38060-5287
(901) 930-3486
Mailing address
155 OAK HOLLOW DR, OAKLAND, TN 38060-5287
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/10/2026
Last updated
04/10/2026
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