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General NPI Number Information
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NPI Number | 1134076482
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Entity Type | Organization
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Legal Business Name | GRACE HAVEN LLC
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Dates
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Enumeration Date | 03/16/2026
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Last Update Date | 03/16/2026
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Provider Practice Location Address
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Address Line | 4413 BELVIEU AVE
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City | BALTIMORE
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State | MD
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Zip | 21215-4216
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Country | US
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Telephone | 410-404-7651
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Fax |
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Provider Business Mailing Address
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Address Line | 11 AYNESLEY CT
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City | OWINGS MILLS
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State | MD
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Zip | 21117-6143
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Country | US
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Telephone | 410-404-7651
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Fax | 443-551-3784
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Authorized Official
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Title or Position | ALM
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Name | DR. PAULA U OHIKU
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Credential | DNP CRNP PMHNP
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Telephone | 410-404-7651
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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