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Organization
I'M STILL STANDING BY GRACE MENTAL HEALTH CLINIC
Active
Organization
I'M STILL STANDING BY GRACE MENTAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PAMELA DUKES MHS, CPC, CAC-AD (PROGRAM OWNER)
(443) 831-0191
Entity
Organization
Contact information
Practice address
1003 E PATAPSCO AVE, BALTIMORE, MD 21225-2228
(410) 355-1379
(410) 355-2350
Mailing address
1003 E PATAPSCO AVE, BALTIMORE, MD 21225-2228
(443) 831-0191
(410) 355-2350
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
BH001052
MD
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
BH001052
MD
261QM0850X
Adult Mental Health Clinic/Center
BH001052
MD
323P00000X
Psychiatric Residential Treatment Facility
BH001052
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH001052
BEHAVIORAL HEALTH ADMINISTRATION
MD
Enumeration date
08/03/2018
Last updated
09/18/2023
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