Healthcare Provider Details

I. General information

NPI: 1841025863
Provider Name (Legal Business Name): GRACELAND MEDICAL AND HOME HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 COMMONWEALTH AVE
CATONSVILLE MD
21228-3044
US

IV. Provider business mailing address

413 COMMONWEALTH AVE
CATONSVILLE MD
21228-3044
US

V. Phone/Fax

Practice location:
  • Phone: 410-826-0194
  • Fax:
Mailing address:
  • Phone: 410-826-0194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: CHARITY OSEI BONNAH
Title or Position: OWNER
Credential: NP
Phone: 410-826-0194