| Organization Name: | GRAND PRAIRIE SERVICES |
| NPI Number: | 1093870602 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHARRONNE WARD (PRESIDENT & CEO) |
| Mailing Address: | 136 - 142 1 2 S. Clinton Bradley |
| State: | IL US |
| Postal Code: | 60915 |
| Phone Number: | 8159392313 |
| Fax Number: | 8159392835 |
| NPI Enumeration Date: | 12/26/2006 |
| NPI Last Update Date: | 05/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |