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Organization

GRACELAND RESIDENTIAL INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. STEPHEN DAVID (CEO)
(919) 525-6764
Entity
Organization

Contact information

Practice address
7003 FOUNTAIN PARK DR, GLENN DALE, MD 20769-9475
(919) 525-6764
Mailing address
7003 FOUNTAIN PARK DR, GLENN DALE, MD 20769-9475
(919) 525-6764

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Enumeration date
02/26/2026
Last updated
02/26/2026
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