Organization
GRACEFILLEDDC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNET F MOFOR (CEO)
(443) 622-6572
Entity
Organization
Contact information
Practice address
5521 COLORADO AVE NW, WASHINGTON, DC 20011-7845
(443) 622-6572
Mailing address
5521 COLORADO AVE NW, WASHINGTON, DC 20011-7845
(443) 622-6572
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
03/16/2026
Last updated
03/16/2026
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