Provider Demographics
NPI:1972331585
Name:STEELE GRACE WELLNESS, LLC
Entity type:Organization
Organization Name:STEELE GRACE WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMI
Authorized Official - Middle Name:L
Authorized Official - Last Name:GILBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:934-200-7003
Mailing Address - Street 1:458 RICHMOND BLVD APT C
Mailing Address - Street 2:
Mailing Address - City:RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-3064
Mailing Address - Country:US
Mailing Address - Phone:934-200-7003
Mailing Address - Fax:
Practice Address - Street 1:157 N OCEAN AVE STE 1
Practice Address - Street 2:
Practice Address - City:PATCHOGUE
Practice Address - State:NY
Practice Address - Zip Code:11772-2016
Practice Address - Country:US
Practice Address - Phone:934-200-7003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty