Healthcare Provider Details

I. General information

NPI: 1336590868
Provider Name (Legal Business Name): GRACE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2016
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2401 W BALTIMORE ST
BALTIMORE MD
21223-2134
US

IV. Provider business mailing address

2000 W BALTIMORE ST
BALTIMORE MD
21223-1558
US

V. Phone/Fax

Practice location:
  • Phone: 410-362-3000
  • Fax:
Mailing address:
  • Phone: 410-362-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE BERKLEY-BROWN
Title or Position: AVP OPERATIONS
Credential:
Phone: 410-362-3378