Organization
SOUTHERN GRACE HEALTHCARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDRIA DAVIS (OWNER)
(870) 898-4576
Entity
Organization
Contact information
Practice address
820 S LOCUST ST, ASHDOWN, AR 71822-4347
(870) 898-4576
(870) 455-4484
Mailing address
820 S LOCUST ST, ASHDOWN, AR 71822-4347
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/20/2021
Last updated
11/18/2024
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