Provider Demographics
NPI:1366221525
Name:A TOUCH OF GRACE PSR
Entity type:Organization
Organization Name:A TOUCH OF GRACE PSR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHERRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:CRISP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-350-4866
Mailing Address - Street 1:1804 HARRIS DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-8310
Mailing Address - Country:US
Mailing Address - Phone:336-350-4866
Mailing Address - Fax:
Practice Address - Street 1:2378 CORPORATION PKWY STE F
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-6749
Practice Address - Country:US
Practice Address - Phone:336-350-4866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health