Organization
AMAZING GRACE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXIS CHANEL WALKER (OWNER/DIRECTER)
(954) 709-1210
Entity
Organization
Contact information
Practice address
3678 W OAKLAND PARK BLVD, LAUDERDALE LAKES, FL 33311-1148
(954) 709-1210
Mailing address
2953 NW 192ND TER, MIAMI GARDENS, FL 33056-2477
(954) 709-1210
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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