Organization
GRACE PSYCHIATRIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUSEUN ADESOLA AKINTUNLAJI, NP (PRESIDENT)
(551) 388-6392
Entity
Organization
Contact information
Practice address
5282 MEDICAL DR STE 605, SAN ANTONIO, TX 78229-6114
(551) 388-6392
(210) 444-2171
Mailing address
720 SNOWY ORCHID LN, DESOTO, TX 75115-6691
(551) 388-6392
(855) 461-3377
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/18/2021
Last updated
09/18/2021
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