Organization
LOVING GRACE PCH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONDA BOOKER (OWNER)
(706) 831-4472
Entity
Organization
Contact information
Practice address
1213 WOOD VALLEY RD, AUGUSTA, GA 30909-2327
(706) 738-9032
(706) 738-9032
Mailing address
1236 12TH ST, AUGUSTA, GA 30901-3238
(706) 364-4379
(706) 364-4378
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
GA
Other
Enumeration date
03/18/2008
Last updated
03/18/2008
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