Provider Demographics
NPI:1932958089
Name:GRATEFUL HEART HEALTHCARE RESOURCES, INC.
Entity type:Organization
Organization Name:GRATEFUL HEART HEALTHCARE RESOURCES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ABRAHAM NERRY
Authorized Official - Middle Name:NKENYEH
Authorized Official - Last Name:NUNGU
Authorized Official - Suffix:
Authorized Official - Credentials:BSN, RN, CM/DN
Authorized Official - Phone:240-602-0785
Mailing Address - Street 1:3904 MAINE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21207-7420
Mailing Address - Country:US
Mailing Address - Phone:240-602-0785
Mailing Address - Fax:
Practice Address - Street 1:537 GREENE ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2731
Practice Address - Country:US
Practice Address - Phone:240-602-0785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility