| Light and Grace LLC | |
|
108 E Ridgeville Blvd Ste A Mount Airy MD 21771-5934 | |
| (667) 770-6549 | |
| (866) 949-4549 |
| Full Name | Light and Grace LLC |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 108 E Ridgeville Blvd Ste A, Mount Airy, Maryland |
| Authorized Official Name and Position | Cherie Rios (OWNER) |
| Authorized Official Contact | 6677706549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Light and Grace LLC 1310 9th Ave Unit 2488 Phenix City AL 36868-5091 Ph: (667) 770-6549 | Light and Grace LLC 108 E Ridgeville Blvd Ste A Mount Airy MD 21771-5934 Ph: (667) 770-6549 |
| NPI Number | 1528863321 |
|---|---|
| Provider Enumeration Date | 02/17/2025 |
| Last Update Date | 02/17/2025 |
| Certification Date | 02/16/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528863321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (NU) | Primary |
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