# GRACE HEALTHCARE SERVICES INC

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

## Provider details

- **NPI number:** 1902581978
- **Authorized official:** SIPHRA NGUM MUKORO PMHNP (NP)
- **Authorized official phone:** (301) 675-3515

## Contact information

- **Practice address:** 5100 BUCKEYSTOWN PIKE STE 250, FREDERICK, MD 21704-8344
- **Practice address phone:** (301) 576-3515
- **Mailing address:** 5100 BUCKEYSTOWN PIKE STE 250, FREDERICK, MD 21704-8344
- **Mailing address phone:** (301) 576-3515

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 06/19/2023
- **Last updated:** 06/20/2023