Organization
SPECIAL GRACES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA MARINO (OWNER)
(409) 658-3411
Entity
Organization
Contact information
Practice address
74 TERRA BELLA DR, MANVEL, TX 77578-3340
(409) 658-3411
Mailing address
PO BOX 841895, PEARLAND, TX 77584-0026
(409) 658-3411
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/16/2013
Last updated
05/16/2013
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