Organization
PEACE & GLORY MANOR, INC
Active
Other names
Peace & Glory Manor Medical Adult & Senior Plus Daycare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLORIA LYNN BROWN - BRISTOL (OWNER)
(443) 386-9959
Entity
Organization
Contact information
Practice address
3829 KILBURN RD, RANDALLSTOWN, MD 21133-4655
(443) 386-9959
(410) 922-4620
Mailing address
3829 KILBURN RD, RANDALLSTOWN, MD 21133-4655
(443) 386-9959
(410) 922-4620
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
—
—
305R00000X
Preferred Provider Organization
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
332BC3200X
Customized Equipment (DME)
—
—
332BN1400X
Nursing Facility Supplies (DME)
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332S00000X
Hearing Aid Equipment
—
—
343800000X
Secured Medical Transport (VAN)
Primary
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
09/14/2009
Last updated
09/14/2009
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