Organization
GRACE BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LEANNA A FOWLDS LCSW (DIRECTOR/ THERAPIST)
(573) 469-2433
Entity
Organization
Contact information
Practice address
57109 QUENTIN DR, CALIFORNIA, MO 65018-6000
(573) 469-2433
Mailing address
2208 MISSOURI BLVD STE 102, JEFFERSON CITY, MO 65109-4742
(573) 469-2433
(573) 550-2436
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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