Grace Line Nursing LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

License

NRSA140028 Issued in MD

Legal business name

GRACE LINE NURSING LLC

Practice address

15445 Depot LN
Upper Marlboro, MD 20772-3157

Phone

(240) 544-8093

NPI assigned

Mar 29, 2018

Organization subpart

No

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

Authorized official

Name

Omobolanle F Babafemi, LLB

Title

Program Manager

Phone

(240) 544-8093

Specialties & licenses 1

Addresses

Other names 1

• GLNursing Doing business as

Locations

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1184129298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15445 DEPOT LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723157",
            "telephone_number": "240-544-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15445 DEPOT LN",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723157",
            "telephone_number": "240-544-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE LINE NURSING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-29",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "BABAFEMI",
        "authorized_official_first_name": "OMOBOLANLE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "240-544-8093",
        "authorized_official_credential": "LLB"
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "MD",
            "license": "NRSA140028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLNursing",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Care Agency in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Nursing Care Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.