Healthcare Provider Details

I. General information

NPI: 1134034424
Provider Name (Legal Business Name): I'M STILL STANDING BY GRACE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 E PATAPSCO AVE
BALTIMORE MD
21225-2228
US

IV. Provider business mailing address

PO BOX 2727
BALTIMORE MD
21225-0727
US

V. Phone/Fax

Practice location:
  • Phone: 410-355-3711
  • Fax: 410-355-3711
Mailing address:
  • Phone: 410-355-3711
  • Fax: 410-355-2350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name: EMMA GOLD
Title or Position: CLINICAL OPERATIONS COORDINATOR
Credential: CPRS
Phone: 410-355-3711