Organization
WITH GRACE SUPPORTIVE LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETHA J JONES (OWNER)
(141) 098-2883
Entity
Organization
Contact information
Practice address
1108 GLENEAGLE RD, BALTIMORE, MD 21239-2254
(410) 982-8834
Mailing address
1026 STAMFORD RD, BALTIMORE, MD 21229-1240
(410) 982-8834
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
04/22/2022
Last updated
02/16/2023
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