Organization
GOLDEN GRACE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAISE BIGABWA (PARTNER/OWNER)
(316) 990-7299
Entity
Organization
Contact information
Practice address
5619 N MERIDIAN CT, WICHITA, KS 67204-6602
(316) 312-0768
Mailing address
5619 N MERIDIAN CT, WICHITA, KS 67204-6602
(316) 312-0768
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/18/2025
Last updated
12/18/2025
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