Organization
GRACE OF SERENITY LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TAMMY MEADE (PRESIDENT)
(602) 441-4690
Entity
Organization
Contact information
Practice address
4620 N 16TH ST, A-101, PHOENIX, AZ 85016-5121
(602) 441-4690
(602) 441-4694
Mailing address
4620 N 16TH ST, A-101, PHOENIX, AZ 85016-5121
(602) 441-4690
(602) 441-4694
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
BH-3929
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
931271
2
AZ
Enumeration date
03/21/2007
Last updated
10/11/2011
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