| Aging Grace Llc | |
|
604 Grain Ct E Millersville MD 21108-1657 | |
| (410) 926-6323 | |
| Not Available |
| Full Name | Aging Grace Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 604 Grain Ct E, Millersville, Maryland |
| Authorized Official Name and Position | Briana N Flowers (CO OWNER/PROVIDER) |
| Authorized Official Contact | 4109266323 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aging Grace Llc 604 Grain Ct E Millersville MD 21108-1657 Ph: (410) 926-6323 | Aging Grace Llc 604 Grain Ct E Millersville MD 21108-1657 Ph: (410) 926-6323 |
| NPI Number | 1578277612 |
|---|---|
| Provider Enumeration Date | 01/12/2023 |
| Last Update Date | 01/12/2023 |
| Certification Date | 01/12/2023 |
| Medicare PECOS PAC ID | 0547605263 |
|---|---|
| Medicare Enrollment ID | O20240304001398 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578277612 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Shareese Kess |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487351169 PECOS PAC ID: 4183069800 Enrollment ID: I20240304001592 |
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