GRACES ROOM LLC NPI 1922966746

NPI Information

  • NPI: 1922966746
  • Provider Name: GRACES ROOM LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 10216 INDIAN SUMMER CT
    BOWIE, MD
    ZIP 20721
  • Phone: (240) 203-7448

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NPI Details

GRACES ROOM LLC is a psychiatric/mental health nurse practitioner in Bowie, MD. GRACES ROOM LLC NPI is 1922966746. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

10216 INDIAN SUMMER CT
BOWIE, MD
ZIP 20721-178
Phone: (240) 203-7448
Fax: (240) 371-0557

The provider's authorized official is Michael Dickson .
The authorized official title is Owner Of Entity and has the following contact phone number (240) 203-7448.

The enumeration date for this NPI number is 1/12/2026 and was last updated on 1/12/2026.

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
1363LP0808XNurse PractitionerPsychiatric/Mental HealthYes

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: 11/21/2025

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