PEACE & GLORY MANOR INC NPI 1104159839

NPI Information

  • NPI: 1104159839
  • Provider Name: PEACE & GLORY MANOR, INC
  • Classification: Clinic/Center - 261QA0600X
  • Specialization: Adult Day Care
  • Entity Type: Organization
  • Former Legal Business Name: PEACE & GLORY MANOR MEDICAL ADULT & SENOIR PLUS DAYCARE CENTER
  • Address: 3829 KILBURN RD
    RANDALLSTOWN, MD
    ZIP 21133
  • Phone: (443) 389-9959

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NPI Details

PEACE & GLORY MANOR, INC is an adult day care clinic center in Randallstown, MD. PEACE & GLORY MANOR, INC NPI is 1104159839. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Peace & Glory Manor Medical Adult & Senoir Plus Daycare Center.

The provider's business location address is:

3829 KILBURN RD
RANDALLSTOWN, MD
ZIP 21133-655
Phone: (443) 389-9959
Fax: (410) 922-4620

The provider's authorized official is Gloria Lynn Brown - Bristol .
The authorized official title is Owner and has the following contact phone number (443) 386-9959.

The enumeration date for this NPI number is 9/14/2009 and was last updated on 9/14/2009.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0000XInternal MedicineCardiovascular DiseaseNo
2207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
3207RX0202XInternal MedicineMedical OncologyNo
4207ZB0001XPathologyBlood Banking & Transfusion MedicineNo
5208U00000XClinical PharmacologyNo
6251300000XLocal Education Agency (LEA)No
7251C00000XDay Training, Developmentally Disabled ServicesNo
8251J00000XNursing CareNo
9251V00000XVoluntary or CharitableNo
10261QE0700XClinic/CenterEnd-Stage Renal Disease (ESRD) TreatmentNo
11261QM0801XClinic/CenterMental Health (Including Community Mental Health Center)No
12261QP2000XClinic/CenterPhysical TherapyNo
13261QR0400XClinic/CenterRehabilitationNo
14261QR0401XClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)No
15261QA0600XClinic/CenterAdult Day CareYes

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: 3/30/2025

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