Organization
GRAY RESIDENTIAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ALICIA GRAY (CEO/OWNER)
(317) 854-5141
Entity
Organization
Contact information
Practice address
9660 COMMERCE DR, CARMEL, IN 46032-7641
(317) 854-5141
(317) 854-4801
Mailing address
9660 COMMERCE DR, CARMEL, IN 46032-7641
(317) 854-5141
(317) 854-4801
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300009019
—
IN
Enumeration date
10/10/2017
Last updated
03/27/2018
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