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Contact Information

GRACE RESIDENTIAL SERVICES, LLC
4117 BROOKSIDE OAKS ROAD
OWINGS MILLS, MD21117
 Phone: 443-677-7130
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Developmental Disabilities

261QD1600X
Indicates primary specialty

NPI Profile & details for GRACE RESIDENTIAL SERVICES, LLC

NPI Number 1033675897
LBN Legal business name GRACE RESIDENTIAL SERVICES, LLC
Authorized official OMOLARA ADEOLA - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 02/18/2019
Last updated 02/18/2019 - About 7 years ago
Identifiers
MD Medicaid 122456
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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