Organization
GRACE HAVEN HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LENA BREWER (OWNER)
(678) 368-0359
Entity
Organization
Contact information
Practice address
4767 HOUSTON RD APT 3113, FLORENCE, KY 41042-4815
(678) 368-0359
Mailing address
4767 HOUSTON RD APT 3113, FLORENCE, KY 41042-4815
(678) 368-0359
Taxonomy
Speciality
Code
Description
License number
State
103TM1800X
Intellectual & Developmental Disabilities Psychologist
Primary
—
—
Other
Enumeration date
02/11/2026
Last updated
02/11/2026
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