NPIMap

Organization Active NPI

Pride Assisted Living, LLC

  • Assisted Living Facility
  • Baltimore, MD
National Provider Identifier
1053908053
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
PRIDE ASSISTED LIVING, LLC
Practice address
1003 Whatcoat St
Baltimore, MD 21217-2220
Phone
(443) 708-3017
NPI assigned
Dec 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Ieshia Latoya Clark
Title
Owner/Manager
Phone
(443) 814-7882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Primary

Addresses

Primary practice location

1003 Whatcoat St
Baltimore, MD 21217-2220

Mailing address

1003 Whatcoat St
Baltimore, MD 21217-2220
Phone (443) 708-3017

Other names 1

  • Pride Assisted Living, LLC Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1053908053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 WHATCOAT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212172220",
            "telephone_number": "443-708-3017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 WHATCOAT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212172220",
            "telephone_number": "443-708-3017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "IESHIA",
        "authorized_official_middle_name": "LATOYA",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "443-814-7882",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pride Assisted Living, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.