SPACE FOR GRACE, LLC (NPI# 1396345351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396345351 |
| Entity Type | Organization |
| Organization Name | SPACE FOR GRACE, LLC |
| Practice Address |
10208 Cascade Run Ct Owings Mills MD 21117-5836 |
| Practice Telephone | 4439857294 |
| Mailing Telephone | 4439857294 |
| Enumeration Date | 2020-10-29 |
| Last Update Date | 2020-10-29 |
| Authorized Official Name | RENEE P LEWIS (OWNER) |
| Authorized Official Telephone | 4438892569 |
| Authorized Official Credential | LCPC, LCADC, NBC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YP1600X |
Counselor Specialization: Pastoral |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Space for Grace, LLC | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | SPACE FOR GRACE, LLC | 161-15 134th Ave, Jamaica, Ny 11434 |
| Street Address |
10208 CASCADE RUN CT |
| City | OWINGS MILLS |
| State | MD |
| Zip Code | 21117-5836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720229701 | Renee Patricia Lewis | Counselor | 10208 Cascade Run Ct, Owings Mills, MD 21117-5836 | 2009-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699303727 | Modern Medicine Express Care | Clinic/Center | 1041 Campbell Meadow Rd, Owings Mills, MD 21117 | 2020-04-01 |
| 1679111892 | Abria Therapy, LLC | Behavioral Analyst | 10451 Mill Run Circle, Suite 400, Owings Mills, MD 21117 | 2019-12-18 |
| 1194384917 | Michele Dawson Overtoom | Pharmacist | Wegmans Pharmacy #125, 10100 Reisterstown Road, Owings Mills, MD 21117 | 2019-06-06 |
| 1033675897 | Grace Residential Services, LLC | Clinic/Center | 4117 Brookside Oaks Road, Owings Mills, MD 21117 | 2019-02-18 |
| 1801373246 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 10270 Mill Run Circle, Owings Mills, MD 21117 | 2018-07-27 |
| 1922513167 | Vamsh Health Services, LLC | Pharmacy | 10309 Grand Central Ave Ste 110, Owings Mills, MD 21117 | 2017-12-11 |
| 1215456652 | Safari Healthcare | Home Health | 4129 Brookside Oak Road, Owings Mills, MD 21117 | 2017-09-18 |
| 1639697964 | Rachel Tova Goldberg | Behavioral Analyst | 11907 Hunting Tweed Dr., Owings Mills, MD 21117 | 2017-09-07 |
| 1528599149 | Nest Home Care, LLC | In Home Supportive Care | 90 Painters Mill Rd Ste 223, Owings Mills, MD 21117 | 2017-03-24 |
| 1508221243 | Quality Home Care, LLC | In Home Supportive Care | 124 Embleton Road, Owings Mills, MD 21117 | 2015-12-23 |
| Find all providers in zip 21117 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619430550 | Jk Health System | Counselor | 20 Bailey Ln, Owings Mills, MD 21117-8000 | 2019-04-08 |
| 1801357652 | Chelsea F Manzon | Counselor | 9199 Reisterstown Rd Ste 104, Owings Mills, MD 21117-4520 | 2019-03-26 |
| 1922564053 | Cherinna Andrea Hardeman | Counselor | 9301 Wheelwright Dr Apt 302, Owings Mills, MD 21117-6862 | 2019-02-13 |
| 1336658723 | Ellen Fitzkee | Counselor | 9917 Sherwood Farm Rd, Owings Mills, MD 21117-5852 | 2017-09-28 |
| 1164946638 | Adeleke Ibironke | Counselor | 12 Clemetis Ct, Owings Mills, MD 21117-5032 | 2017-07-27 |
| 1033643218 | Steven Jamal Howard | Counselor | 9915 Sherwood Farm Rd, Owings Mills, MD 21117-5852 | 2017-04-14 |
| 1558715847 | Michael Knight Jr. | Counselor | 9453 Common Brook Rd Apt 303, Owings Mills, MD 21117-7587 | 2016-04-22 |
| 1730533498 | Denise Waltos | Counselor | 2205 Shaded Brook Dr, Owings Mills, MD 21117-2347 | 2016-04-19 |
| 1861834475 | Brenda Conway | Counselor | 9401 White Cedar Dr, Apt 309, Owings Mills, MD 21117-7516 | 2013-07-24 |
| 1275801904 | Dana Yates | Counselor | 10087 Red Run Blvd., Suite 200, Owings Mills, MD 21117 | 2011-12-08 |
| Find all providers in OWINGS MILLS | ||||
| City | OWINGS MILLS |
| Zip Code | 21117 |
Please comment or provide details below to improve the information on SPACE FOR GRACE, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.