Organization
HOME OF GRACE NC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENEA CHURCH (MRS)
(757) 779-4593
Entity
Organization
Contact information
Practice address
2501 LYON ST, GASTONIA, NC 28052-6251
(757) 779-4593
Mailing address
301 S MCDOWELL ST STE 125-1745, CHARLOTTE, NC 28204-2623
(757) 779-4593
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
07/02/2024
Last updated
07/05/2024
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