NPIMap

Organization Active NPI

Heavenly Grace Assistant Living Facility, Inc

  • Assisted Living Facility
  • Baltimore, MD
National Provider Identifier
1447559406
Registry record updated Mar 16, 2011
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Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
30AL3017B Issued in MD
Legal business name
HEAVENLY GRACE ASSISTANT LIVING FACILITY, INC
Practice address
1210 Gittings Ave
Baltimore, MD 21239-1720
Phone
(443) 271-0884
Fax
(410) 435-7259
NPI assigned
Mar 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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

Authorized official

Name
Mrs. Brenda A West, MED TECH
Title
Manager
Phone
(443) 271-0884

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 30AL3017B MD Primary

Addresses

Primary practice location

1210 Gittings Ave
Baltimore, MD 21239-1720

Mailing address

PO Box 66493
Baltimore, MD 21239-6493
Phone (443) 271-0884

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1300233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300233600000",
    "number": "1447559406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66493",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212396493",
            "telephone_number": "443-271-0884",
            "fax_number": "410-435-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 GITTINGS AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212391720",
            "telephone_number": "443-271-0884",
            "fax_number": "410-435-7259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVENLY GRACE ASSISTANT LIVING FACILITY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-16",
        "last_updated": "2011-03-16",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "443-271-0884",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MED TECH"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": "30AL3017B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Mar 16, 2011; 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.