Organization
I'M STILL STANDING BY GRACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS PAMELA DUKES MHS, CPC, CAC-AD (CEO)
(443) 831-0191
Entity
Organization
Contact information
Practice address
1003 E PATAPSCO AVE, BALTIMORE, MD 21225-2228
(443) 312-6237
(443) 312-6461
Mailing address
PO BOX 2727, BALTIMORE, MD 21225-0727
(443) 831-0191
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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