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Organization

RETURN TO GRACE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JENNIFER WHITE (CEO)
(979) 422-8185
Entity
Organization

Contact information

Practice address
111 W 5TH ST, TYLER, TX 75701-4006
(979) 422-8185
Mailing address
3604 DONNA DR, TYLER, TX 75702-6507
(979) 422-8185

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
174200000X
Meals Provider
177F00000X
Lodging Provider
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency
252Y00000X
Early Intervention Provider Agency
261QR0400X
Rehabilitation Clinic/Center
261QR0800X
Recovery Care Clinic/Center
282J00000X
Religious Nonmedical Health Care Institution
324500000X
Substance Abuse Rehabilitation Facility
Primary
343900000X
Non-emergency Medical Transport (VAN)

Other

Enumeration date
06/30/2025
Last updated
06/30/2025
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