NPIMap

Organization Active NPI

Peace & Glory Manor, Inc

  • Adult Day Care Clinic/Center
  • Randallstown, MD
National Provider Identifier
1104159839
Registry record updated Sep 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
PEACE & GLORY MANOR, INC
Practice address
3829 Kilburn Rd
Randallstown, MD 21133-4655
Phone
(443) 389-9959
Fax
(410) 922-4620
NPI assigned
Sep 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2009

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

Authorized official

Name
Ms. Gloria Lynn Brown - Bristol
Title
Owner
Phone
(443) 386-9959

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RC0000X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RE0101X
Medical Oncology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207RX0202X
Blood Banking & Transfusion Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207ZB0001X
Clinical Pharmacology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208U00000X
Local Education Agency (LEA) 251300000X
Developmentally Disabled Services Day Training Agency 251C00000X
Nursing Care Agency 251J00000X
Voluntary or Charitable Agency 251V00000X
Adult Day Care Clinic/Center 261QA0600X Primary
End-Stage Renal Disease (ESRD) Treatment Clinic/Center 261QE0700X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Physical Therapy Clinic/Center 261QP2000X
Rehabilitation Clinic/Center 261QR0400X
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X

Addresses

Primary practice location

3829 Kilburn Rd
Randallstown, MD 21133-4655

Mailing address

3829 Kilburn Rd
Randallstown, MD 21133-4655
Phone (443) 386-9959

Other names 1

  • Peace & Glory Manor Medical Adult & Senoir Plus Daycare Center Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Peace Glory Manor Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1252886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252886400000",
    "number": "1104159839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3829 KILBURN RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334655",
            "telephone_number": "443-386-9959",
            "fax_number": "410-922-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3829 KILBURN RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211334655",
            "telephone_number": "443-389-9959",
            "fax_number": "410-922-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE & GLORY MANOR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-14",
        "last_updated": "2009-09-14",
        "status": "A",
        "authorized_official_last_name": "BROWN - BRISTOL",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-386-9959",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine, Medical Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207ZB0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208U00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Clinical Pharmacology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peace & Glory Manor Medical Adult & Senoir Plus Daycare Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; 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.