Individual ProviderTierra Leah GrantBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address421 Fayetteville St, Raleigh, NC 27601-1792(888) 880-9270PECOS EnrollmentBased on the most recent information from CMS, provider Tierra Leah Grant does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1043938749Provider TypeIndividualFull NameGrant, Tierra LeahGenderFemaleSole ProprietorNoEnumeration Date8/18/2022Last Updated5/12/2024Contact InformationPractice LocationPractice Address421 Fayetteville St, Raleigh, NC 27601-1792Phone(888) 880-9270FaxUnlisted FaxMailing LocationMailing Address603 Bladestone Ct, Apex, NC 27502-1355PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer