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Organization

GRACE IN MOTION REHAB LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CELINA HAWTHORNE (OWNER, PROVIDER)
(936) 585-1360
Entity
Organization

Contact information

Practice address
3611 NORTH ST STE 110, NACOGDOCHES, TX 75965-2402
(936) 585-1360
Mailing address
PO BOX 630642, NACOGDOCHES, TX 75963-0642

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2355S0801X
Speech-Language Assistant
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
12/13/2024
Last updated
12/13/2024
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