Provider Demographics
NPI:1598654980
Name:RETURN TO GRACE
Entity type:Organization
Organization Name:RETURN TO GRACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-422-8185
Mailing Address - Street 1:3604 DONNA DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-6507
Mailing Address - Country:US
Mailing Address - Phone:979-422-8185
Mailing Address - Fax:
Practice Address - Street 1:111 W 5TH ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-4006
Practice Address - Country:US
Practice Address - Phone:979-422-8185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No174200000XOther Service ProvidersMeals
No252Y00000XAgenciesEarly Intervention Provider Agency
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care
No282J00000XHospitalsReligious Nonmedical Health Care Institution
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)