Organization
I'M STILL STANDING BY GRACE MENTAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PAMELA DUKES MHS, CPC, CAC-AD (PROGRAM OWNER)
(443) 831-0191
Entity
Organization
Contact information
Practice address
1003 E PATAPSCO AVE, BALTIMORE, MD 21225-2228
(410) 355-1379
(410) 355-2350
Mailing address
1003 E PATAPSCO AVE, BALTIMORE, MD 21225-2228
(443) 831-0191
(410) 355-2350
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
BH001052
MD
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
BH001052
MD
261QM0850X
Adult Mental Health Clinic/Center
BH001052
MD
323P00000X
Psychiatric Residential Treatment Facility
BH001052
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BH001052
BEHAVIORAL HEALTH ADMINISTRATION
MD
Enumeration date
08/03/2018
Last updated
09/18/2023
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