Provider Demographics
NPI:1124737879
Name:GRACE AND HEALING LLC DBA GRACE AND HEALING THERAPY SERVICES
Entity type:Organization
Organization Name:GRACE AND HEALING LLC DBA GRACE AND HEALING THERAPY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LCADC
Authorized Official - Phone:201-528-3315
Mailing Address - Street 1:130 MAPLE AVE STE 10B
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-1738
Mailing Address - Country:US
Mailing Address - Phone:201-528-3315
Mailing Address - Fax:
Practice Address - Street 1:130 MAPLE AVE STE 10B
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-1738
Practice Address - Country:US
Practice Address - Phone:201-528-3315
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health