Provider Demographics
NPI:1962279141
Name:GRACE VENTURE INC
Entity type:Organization
Organization Name:GRACE VENTURE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOYCE
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-850-8046
Mailing Address - Street 1:PO BOX 3526
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21742-3526
Mailing Address - Country:US
Mailing Address - Phone:240-850-8046
Mailing Address - Fax:
Practice Address - Street 1:16927-16929 SHINHAM RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-2218
Practice Address - Country:US
Practice Address - Phone:240-850-8046
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-07
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No177F00000XOther Service ProvidersLodging
No251S00000XAgenciesCommunity/Behavioral Health