Organization
HEAVENLY GRACE ASSISTANT LIVING FACILITY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA A WEST MED TECH (MANAGER)
(443) 271-0884
Entity
Organization
Contact information
Practice address
1210 GITTINGS AVE, BALTIMORE, MD 21239-1720
(443) 271-0884
(410) 435-7259
Mailing address
PO BOX 66493, BALTIMORE, MD 21239-6493
(443) 271-0884
(410) 435-7259
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
30AL3017B
MD
Other
Enumeration date
03/16/2011
Last updated
03/16/2011
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