# PEACE & GLORY MANOR, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023344066
- **Authorized official:** MS. GLORIA LYNN BROWN - BRISTOL (FOUNDER COE/ EXCUTIVE OFFER)
- **Authorized official phone:** (410) 922-2617

## Contact information

- **Practice address:** 3829 KILBURN RD, RANDALLSTOWN, MD 21133-4655
- **Practice address phone:** (410) 922-2617
- **Practice address fax:** (410) 922-4620
- **Mailing address:** 3829 KILBURN RD, RANDALLSTOWN, MD 21133-4655
- **Mailing address phone:** (410) 922-2617
- **Mailing address fax:** (410) 922-4620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WP2201X | Ambulatory Care Registered Nurse | 03AL1070-A | MD | — |
| 163WW0000X | Wound Care Registered Nurse | 03AL1070-A | MD | — |
| 347B00000X | Bus | 03AL1070-A | MD | — |
| 347C00000X | Private Vehicle | 03AL1070-A | MD | — |
| 372600000X | Adult Companion | 03AL1070-A | MD | — |
| 3747A0650X | Attendant Care Provider | 03AL1070-A | MD | — |
| 3747P1801X | Personal Care Attendant | 03AL1070-A | MD | — |
| 376K00000X | Nurse's Aide | 03AL1070-A | MD | Yes |

## Other

- **Enumeration date:** 10/27/2009
- **Last updated:** 10/27/2009