Organization
GROUP RESIDENTIAL AND CARE ESTABLISHMENT
Active
Other names
GRACE, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RODNEY JEROME HAWKINS (DIRECTOR)
(757) 325-8399
Entity
Organization
Contact information
Practice address
2021B CUNNINGHAM DR, SUITE 3, HAMPTON, VA 23666-3326
(757) 325-8399
(757) 325-8321
Mailing address
PO BOX 8227, HAMPTON, VA 23666-0280
(757) 325-8399
(757) 325-8321
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
71303011
VA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
71301001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0101420900
—
VA
Enumeration date
09/21/2015
Last updated
09/21/2015
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