Organization
PEACE & GLORY MANOR,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GLORIA LYNN BROWN - BRISTOL (FOUNDER CEO, PRESIDENT)
(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) 922-4620
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
302R00000X
Health Maintenance Organization
—
MD
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
—
314000000X
Skilled Nursing Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347B00000X
Bus
—
MD
347C00000X
Private Vehicle
—
—
Other
Enumeration date
10/13/2009
Last updated
10/13/2009
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