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BY GRACE INC NPI 1538567961


NPI Information

NPI: 1538567961
Provider Name: BY GRACE, INC

Doing Business As: BY GRACE COUNSELING SERVICES

Classification: Point of Service - 305S00000X
Entity Type: Organization

CLIA Number: 21D2119165

Address:
1002 E PATAPSCO AVE
BALTIMORE, MD
ZIP 21225
Phone: (410) 355-3711
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BY GRACE, INC is a point of service in Baltimore, MD. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. BY GRACE, INC NPI is 1538567961. The provider is registered as an organization entity type.
The provider Is Doing Business As By Grace Counseling Services.

The provider's business location address is:

1002 E PATAPSCO AVE
BALTIMORE, MD
ZIP 21225-229
Phone: (410) 355-3711
Fax: (410) 355-3971

The provider's authorized official is Pamela Dukes .
The authorized official title is Ceo/program Sponsor and has the following contact phone number (443) 831-0191.

The CLIA number assigned to this NPI record is 21D2119165 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/17/2014 and was last updated on 12/17/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305S00000XPoint of Service102166MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1102166MEDICAIDMARYLAND

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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