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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