Organization
GRACE RECOVERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LASHONE ARNETT LCSW (OWNER)
(973) 769-3699
Entity
Organization
Contact information
Practice address
40 GALESI DR STE 26, WAYNE, NJ 07470-4841
(973) 769-3699
Mailing address
52 ELBERON AVE, PATERSON, NJ 07502-2025
(973) 769-3699
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
106H00000X
Marriage & Family Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1407204415
—
NJ
Enumeration date
12/28/2018
Last updated
03/14/2019
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