Organization
GRACED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALICIA WASHINGTON MA (EXECUTIVE DIRECTOR)
(443) 404-0779
Entity
Organization
Contact information
Practice address
1101 KRUPER AVE APT A, HOPEWELL, VA 23860-6030
(443) 404-0779
Mailing address
1101 KRUPER AVE APT A, HOPEWELL, VA 23860-6030
(443) 404-0779
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
04/06/2020
Last updated
04/06/2020
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