Provider Demographics
NPI:1144546599
Name:GRACEFUL HEALTH CENTER
Entity type:Organization
Organization Name:GRACEFUL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NKEIRU
Authorized Official - Middle Name:P
Authorized Official - Last Name:UCHEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-607-5664
Mailing Address - Street 1:14922 HAVENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5662
Mailing Address - Country:US
Mailing Address - Phone:832-607-5664
Mailing Address - Fax:
Practice Address - Street 1:5231 BEECHNUT STREET
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096
Practice Address - Country:US
Practice Address - Phone:832-607-5664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-09
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities