Organization
AMAZING GRACE HEALTH CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BINETTE FORZONG FONGE PHD (PRESIDENT)
(202) 390-7313
Entity
Organization
Contact information
Practice address
5135 BRIDESHEAD CT, WHITE PLAINS, MD 20695-3186
(202) 390-7313
Mailing address
5135 BRIDESHEAD CT, WHITE PLAINS, MD 20695-3186
(202) 390-7313
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
11/30/2023
Last updated
12/02/2023
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