Organization
GRACE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHNATHAN SHANE BLACK (COUNSELOR)
(251) 648-0835
Entity
Organization
Contact information
Practice address
7120 AIRPORT BLVD, MOBILE, AL 36608
(251) 345-3303
Mailing address
7120 AIRPORT BLVD, MOBILE, AL 36608-4502
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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