Organization
GRACE THEIOS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IGOR GONZALEZ (EXECUTIVE DIRECTOR)
(417) 392-1297
Entity
Organization
Contact information
Practice address
6031 COUNTY ROAD 105, CARTHAGE, MO 64836
(417) 317-4434
Mailing address
6031 COUNTY ROAD 105, CARTHAGE, MO 64836
(417) 317-4434
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
MO
Other
Enumeration date
12/28/2016
Last updated
06/26/2025
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