Grace Harbor Behavioral Health LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

GRACE HARBOR BEHAVIORAL HEALTH LLC

Practice address

2106 S 17TH St
Wilmington, NC 28401-7408

Phone

(704) 838-9222

Fax

(704) 408-0887

NPI assigned

Nov 4, 2026

Last updated

Nov 4, 2026By 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

Brandon James Medina

Title

Owner/Manager

Phone

(704) 838-9222

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1793750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1793750400000",
    "number": "1336048446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4009 MASONBORO LOOP RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284093640",
            "telephone_number": "704-838-9222",
            "fax_number": "910-408-0887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2106 S 17TH ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017408",
            "telephone_number": "704-838-9222",
            "fax_number": "704-408-0887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE HARBOR BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-11-04",
        "last_updated": "2026-11-04",
        "certification_date": "2026-11-04",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "704-838-9222"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martin Scott Gould, DDS, MS
• Ashley Elizabeth Gousios, MS, RDN, LDN, CNSC
• Alyssa Gowdy, PA-C
• Grant Gowing
• Whitney Laurel Grabarz, LCSWA
• Grace of Jordan Home Care LLC (Grace of Jordan Home Care)
• Sarah Elizabeth Grady
• Jason Allen Graf, D.C.
• Laura Lynn Graff, M.A., CCC-SLP
• Barbara Graham, MSW, LCSWA

• Substance Abuse Rehabilitation Facility in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Substance Abuse Rehabilitation Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.