Organization
ABUNDANT GRACE SUPPORT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TETTEH NII ADDY DR. (ASSISTANT MANAGER)
(757) 268-9992
Entity
Organization
Contact information
Practice address
102 HUFF DR, STAFFORD, VA 22554-3360
(540) 818-4825
Mailing address
102 HUFF DR, STAFFORD, VA 22554-3360
(540) 818-4825
Taxonomy
Speciality
Code
Description
License number
State
2084B0040X
Behavioral Neurology & Neuropsychiatry Physician
Primary
—
—
Other
Enumeration date
07/22/2024
Last updated
07/22/2024
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