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Organization
GRACES ROOM LLC
Active
Organization
GRACES ROOM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DICKSON DNP (OWNER OF ENTITY)
(240) 203-7448
Entity
Organization
Contact information
Practice address
10216 INDIAN SUMMER CT, BOWIE, MD 20721-3178
(240) 203-7448
(240) 371-0557
Mailing address
3030 GREENMOUNT AVE STE 300, BALTIMORE, MD 21218-6907
(240) 203-7448
(240) 371-0557
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/12/2026
Last updated
01/12/2026
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