Organization
I'M STILL STANDING BY GRACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. YVONNE BROCK MA,CAC-AD,ICADC,CTS (CEO/PRESIDENT)
(301) 821-3805
Entity
Organization
Contact information
Practice address
1003 E PATAPSCO AVE, BALTIMORE, MD 21225-2228
(301) 821-3805
Mailing address
1003 E PATAPSCO AVE, BALTIMORE, MD 21225-2228
(301) 821-3805
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
905037
MD
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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