Organization
DEI GRACIA HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHALIE ROSINE KORI NKENLIFACK MANHENKEU APRN (MANAGER)
(217) 819-7328
Entity
Organization
Contact information
Practice address
909 N CUNNINGHAM AVE, URBANA, IL 61802-1744
(217) 607-8110
Mailing address
1409 OGELTHORPE AVE, URBANA, IL 61802-4749
(217) 819-7328
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
08/28/2025
Last updated
05/13/2026
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