Organization
GRACE QUALITY GROUPHOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CASSANDRA DELISSAINT (GROUP HOME MANAGER)
(682) 301-2042
Entity
Organization
Contact information
Practice address
5900 EMBER GLEN DR, HALTOM CITY, TX 76137-5809
(682) 301-2042
Mailing address
5900 EMBER GLEN DR, HALTOM CITY, TX 76137-5809
(682) 301-2042
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
11/18/2016
Last updated
11/18/2016
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