Organization
THE GRACE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDNOCK NTUNGUMU KHONDE (OWNER/ADMINISTRATOR)
(207) 352-8862
Entity
Organization
Contact information
Practice address
10 COLUMBIA ST UNIT 2, LEWISTON, ME 04240-4802
(207) 352-8862
Mailing address
10 COLUMBIA ST UNIT 2, LEWISTON, ME 04240-4802
(207) 352-8862
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
11/01/2023
Last updated
11/01/2023
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