Organization
BY GRACE, INC
Active
Organization
BY GRACE, INC
Active
Other names
By Grace Counseling Services
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PAMELA DUKES MHS, CPC, CAC-AD (CEO/PROGRAM SPONSOR)
(443) 831-0191
Entity
Organization
Contact information
Practice address
1002 E PATAPSCO AVE, BALTIMORE, MD 21225-2229
(410) 355-3711
(410) 355-3971
Mailing address
PO BOX 2727, BALTIMORE, MD 21225-0727
(410) 355-3711
(410) 355-3971
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
102166
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102166
—
MD
Enumeration date
12/17/2014
Last updated
12/17/2014
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