| Grace Path Wellness Center Llc | |
|
1747 Tysons Central St Apt 2302 Tysons VA 22182-6057 | |
| (925) 775-8253 | |
| Not Available |
| Full Name | Grace Path Wellness Center Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1747 Tysons Central St Apt 2302, Tysons, Virginia |
| Authorized Official Name and Position | Marcel Grisard (OWNER) |
| Authorized Official Contact | 9257758253 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Path Wellness Center Llc 5709 Edgewood Ave Lynchburg VA 24502-1903 Ph: (925) 775-8253 | Grace Path Wellness Center Llc 1747 Tysons Central St Apt 2302 Tysons VA 22182-6057 Ph: (925) 775-8253 |
| NPI Number | 1205762069 |
|---|---|
| Provider Enumeration Date | 06/19/2026 |
| Last Update Date | 06/19/2026 |
| Certification Date | 06/19/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205762069 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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