Provider Demographics
NPI:1750267977
Name:A PLACE OF GRACE
Entity type:Organization
Organization Name:A PLACE OF GRACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWSER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-722-6838
Mailing Address - Street 1:10 W EAGER ST STE 400
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21201-5471
Mailing Address - Country:US
Mailing Address - Phone:443-722-6838
Mailing Address - Fax:443-722-6838
Practice Address - Street 1:2328 MCCULLOH ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21217-3543
Practice Address - Country:US
Practice Address - Phone:443-722-6838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities