Provider Demographics
NPI:1679378111
Name:GRACE FAMILY AND RELATIONSHIP THERAPY
Entity type:Organization
Organization Name:GRACE FAMILY AND RELATIONSHIP THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TONEY
Authorized Official - Suffix:
Authorized Official - Credentials:DR, PSY DLPCT
Authorized Official - Phone:504-583-5822
Mailing Address - Street 1:1112 FOREST RIDGE LOOP
Mailing Address - Street 2:
Mailing Address - City:PEARL RIVER
Mailing Address - State:LA
Mailing Address - Zip Code:70452-3731
Mailing Address - Country:US
Mailing Address - Phone:504-583-8222
Mailing Address - Fax:
Practice Address - Street 1:1112 FOREST RIDGE LOOP
Practice Address - Street 2:PEARL RIVER
Practice Address - City:LOUISIANA
Practice Address - State:LA
Practice Address - Zip Code:70452-3731
Practice Address - Country:US
Practice Address - Phone:504-345-9728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health