Organization
ESSENCE OF GRACE LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CASONDRA BENNETT (DIRECTOR)
(850) 557-9204
Entity
Organization
Contact information
Practice address
1258 CEDAR CENTER DR, TALLAHASSEE, FL 32301-4876
(850) 629-4599
Mailing address
92 TILLIS LN, CRAWFORDVILLE, FL 32327-8902
(850) 557-9204
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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