Organization
GRACEFUL RESIDENTIAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD OGACHI AREBA (CEO)
(612) 205-1423
Entity
Organization
Contact information
Practice address
49 ARLINGTON, ARLINGTON COURT, JASPER, IN 47546-3552
(612) 205-1423
Mailing address
49 ARLINGTON, ARLINGTON COURT, JASPER, IN 47546-3552
(612) 205-1423
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
12/11/2024
Last updated
12/12/2024
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