Provider Demographics
NPI:1235020090
Name:FAVOR & GRACE INC
Entity type:Organization
Organization Name:FAVOR & GRACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLUWATOYIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OLUWAPELUMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:928-210-7604
Mailing Address - Street 1:14313 S CAMINO EL GALAN
Mailing Address - Street 2:
Mailing Address - City:SAHUARITA
Mailing Address - State:AZ
Mailing Address - Zip Code:85629-8475
Mailing Address - Country:US
Mailing Address - Phone:928-210-7604
Mailing Address - Fax:
Practice Address - Street 1:14313 S CAMINO EL GALAN
Practice Address - Street 2:
Practice Address - City:SAHUARITA
Practice Address - State:AZ
Practice Address - Zip Code:85629-8475
Practice Address - Country:US
Practice Address - Phone:928-210-7604
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-10
Last Update Date:2025-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children