Organization
GRACE HOUSE IOP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICA CROWLEY (CEO)
(443) 517-9338
Entity
Organization
Contact information
Practice address
1401 MADISON PARK DR, GLEN BURNIE, MD 21061-5881
(410) 903-6483
Mailing address
1401 MADISON PARK DR, GLEN BURNIE, MD 21061-5881
(410) 903-6483
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
08/04/2022
Last updated
10/19/2022
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