Organization
GRAYBRIDGE HEALTH, NFP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH J GRAYER JR. CEO (CEO)
(224) 360-7103
Entity
Organization
Contact information
Practice address
520 E LINCOLN AVE, LIBERTYVILLE, IL 60048-2923
(224) 360-7103
Mailing address
520 E LINCOLN AVE, LIBERTYVILLE, IL 60048-2923
(224) 360-7103
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
—
—
251V00000X
Voluntary or Charitable Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
NA
—
Enumeration date
11/28/2022
Last updated
11/28/2022
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