Organization
AMAZING GRACE ASSISTED LIVING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONTRELL THORNTON (CEO)
(314) 323-6803
Entity
Organization
Contact information
Practice address
14812 STRATFORD CT APT B, BRIDGETON, MO 63044-1962
(314) 323-6803
(314) 542-1111
Mailing address
14812 STRATFORD CT APT B, BRIDGETON, MO 63044-1962
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/03/2017
Last updated
01/03/2017
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