Peace & Glory Manor, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

03AL1070-A Issued in MD

Legal business name

PEACE & GLORY MANOR, LLC

Practice address

3829 Kilburn Rd
Randallstown, MD 21133-4655

Phone

(410) 922-2617

Fax

(410) 922-4620

NPI assigned

Oct 27, 2009

Organization subpart

No

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

Founder Ceo/ Excutive Officer

Phone

(410) 922-2617

Specialties & licenses 13

Addresses

Tax ID family

Peace Glory Manor LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Peace & Glory Manor, LLC

  • Nurse's Aide
  • Randallstown, MD
  • NPI 1023344066
  NPD tax ID
• Peace & Glory Manor,Inc

  • Assisted Living Facility
  • Randallstown, MD
  • NPI 1952636649
  NPD tax ID

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256601600000",
    "number": "1821324849",
    "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": "410-922-2617",
            "fax_number": "410-922-2462"
        },
        {
            "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": "410-922-2617",
            "fax_number": "410-922-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE & GLORY MANOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A",
        "authorized_official_last_name": "BROWN - BRISTOL",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "FOUNDER CEO/ EXCUTIVE OFFICER",
        "authorized_official_telephone_number": "410-922-2617",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "133VN1005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Renal",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "136A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietetic Technician, Registered",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "163WA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "163WA2000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Administrator",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "163WC1600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": true
        },
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "MD",
            "license": "03AL1070-A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yashika Mayur Patel
• Peace & Glory Manor, Inc (Peace & Glory Manor Medical Adult & Senior Plus Daycare Center)
• Peace & Glory Manor, Inc
• Peace & Glory Manor, Inc
• Peace & Glory Manor, LLC
• Peace & Glory Manor,Inc
• Peace and Glory, Inc
• Peace of Mind Healthcare Management , Limited Liability Company Rsa-3 (peace of mind healthcare management LLC)
• Tonya M. Pease, CRNA
• Karen Y Perkins, M.D.

• Assisted Living Facility in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 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.