# GRACES ROOM LLC

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

## Provider details

- **NPI number:** 1922966746
- **Authorized official:** MICHAEL DICKSON DNP (OWNER OF ENTITY)
- **Authorized official phone:** (240) 203-7448

## Contact information

- **Practice address:** 10216 INDIAN SUMMER CT, BOWIE, MD 20721-3178
- **Practice address phone:** (240) 203-7448
- **Practice address fax:** (240) 371-0557
- **Mailing address:** 3030 GREENMOUNT AVE STE 300, BALTIMORE, MD 21218-6907
- **Mailing address phone:** (240) 203-7448
- **Mailing address fax:** (240) 371-0557

## 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:** 01/12/2026
- **Last updated:** 01/12/2026