Organization
GRACE RELIANT HEALTHCARE, LLC
Active
Other names
Grace Reliant Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SUSAN KAY STONE (MANAGING MEMBER)
(573) 204-9200
Entity
Organization
Contact information
Practice address
510 W MAIN ST, JACKSON, MO 63755-1741
(573) 204-9200
(573) 243-7133
Mailing address
PO BOX 332, JACKSON, MO 63755-0332
(573) 204-9200
(573) 243-7743
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
MO
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
MO
Other
Enumeration date
02/24/2015
Last updated
05/01/2015
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