Organization
GRACESTREAMSCARE
Active
Organization
GRACESTREAMSCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMARACHI GRACE ONYEFORO LPN (NURSE) (ADMINISTRATOR)
(480) 310-7411
Entity
Organization
Contact information
Practice address
3707 E SOUTHERN AVE STE 2064, MESA, AZ 85206-6218
(480) 310-7411
Mailing address
3707 E SOUTHERN AVE STE 2064, MESA, AZ 85206-6218
(480) 746-9637
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
—
—
Other
Enumeration date
06/26/2024
Last updated
06/26/2024
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