Organization
GRACE MENTAL HEALTH SERVICES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY M NDUMBE PHMNP (SOLE OWNER/ADMIN)
(800) 789-3543
Entity
Organization
Contact information
Practice address
2350 W HIGHWAY 89A # 1023, SEDONA, AZ 86336-5344
(800) 789-3543
(928) 496-2133
Mailing address
15784 W DESERT MIRAGE DR, SURPRISE, AZ 85379-4639
(800) 789-3543
(928) 496-2133
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/28/2021
Last updated
08/18/2021
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