Sober by Grace, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

67601 Issued in TX

Legal business name

SOBER BY GRACE, INC.

Practice address

2451 Bomar Ave
Fort Worth, TX 76103-2211

Phone

(817) 386-7584

NPI assigned

Nov 15, 2012

Last updated

Nov 15, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Bryce E Hudnall

Title

Director

Phone

(817) 606-9580

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1033453170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1056 SAGEWOOD LN",
            "city": "SAGINAW",
            "state": "TX",
            "postal_code": "761314805",
            "telephone_number": "817-606-9580",
            "fax_number": "817-887-1347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 BOMAR AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761032211",
            "telephone_number": "817-386-7584"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOBER BY GRACE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "HUDNALL",
        "authorized_official_first_name": "BRYCE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "817-606-9580",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "TX",
            "license": "67601",
            "primary": true
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "TX",
            "license": "67601",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Sweeney Snyder, CNS
• Heather Amelia Lynn Snyder, LPC
• Jeffrey Scott Snyder, O.D.
• Nichole J Snyder, D.C.
• Raina Dee Sobarzo
• Social Kids LLC
• Social Soul Therapy PLLC
• Social Thinking North Texas
• J'la S Sockwell, RN
• Abigail Joy Soderdahl, PA-C

• Community/Behavioral Health Agency in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Community/Behavioral Health Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.