Organization
BY GRACE RECOVERY HOMES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX MAINA (OWNER /OPERATOR)
(913) 544-5902
Entity
Organization
Contact information
Practice address
1819 OAKLEY CT, STOCKTON, CA 95206-6357
(913) 544-5902
Mailing address
1819 OAKLEY CT, STOCKTON, CA 95206-6357
Taxonomy
Speciality
Code
Description
License number
State
177F00000X
Lodging Provider
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
276400000X
Substance Use Disorder Rehabilitation Hospital Unit
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
310500000X
Mental Illness Intermediate Care Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
12/09/2024
Last updated
12/09/2024
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