Organization
A PLACE JUST FOR ME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT TERRY GRAHAM NDP (PRESIDENT/CEO)
(443) 684-2214
Entity
Organization
Contact information
Practice address
4670 WILLIAMS WHARF RD, SAINT LEONARD, MD 20685-3044
(443) 684-2214
(443) 951-9005
Mailing address
4670 WILLIAMS WHARF RD, SAINT LEONARD, MD 20685-3044
(443) 684-2214
(443) 951-9005
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
04A1.0060-A
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04A1.0060-A
STATE OF MARYLAND DEPART OF HEALTH OFFICE OF HEALTH CARE QUALITY
MD
Enumeration date
09/03/2018
Last updated
09/03/2018
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