| NPI | 1346061124 |
|---|---|
| Other Name | GRACEWAY HEALTH CARE AL LONG GREEN |
| Entity Type | Organization |
| Authorized Contact | KRYSTLE D BROWN Billing Manager 410-870-9380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2024-10-23 |
| Last Update Date | 2024-11-21 |