Organization
PEACE & GLORY MANOR, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLORIA LYNN BROWN - BRISTOL (FOUNDER CEO/ EXCUTIVE OFFICER)
(410) 922-2617
Entity
Organization
Contact information
Practice address
3829 KILBURN RD, RANDALLSTOWN, MD 21133-4655
(410) 922-2617
(410) 922-4620
Mailing address
3829 KILBURN RD, RANDALLSTOWN, MD 21133-4655
(410) 922-2617
(410) 922-2462
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
03AL1070-A
MD
133N00000X
Nutritionist
03AL1070-A
MD
133NN1002X
Nutrition Education Nutritionist
03AL1070-A
MD
133VN1005X
Renal Nutrition Registered Dietitian
03AL1070-A
MD
136A00000X
Registered Dietetic Technician
03AL1070-A
MD
163W00000X
Registered Nurse
03AL1070-A
MD
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
03AL1070-A
MD
163WA2000X
Administrator Registered Nurse
03AL1070-A
MD
163WC0400X
Case Management Registered Nurse
03AL1070-A
MD
163WC1600X
Continuing Education/Staff Development Registered Nurse
03AL1070-A
MD
163WD0400X
Diabetes Educator Registered Nurse
03AL1070-A
MD
310400000X
Assisted Living Facility
Primary
03AL1070-A
MD
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
03AL1070-A
MD
Other
Enumeration date
10/27/2009
Last updated
10/27/2009
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