Provider Demographics
NPI:1700543105
Name:GRAMPS ASSISTED LIVING
Entity Type:Organization
Organization Name:GRAMPS ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:VANITA
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-802-1117
Mailing Address - Street 1:3140 LEEDS ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-3817
Mailing Address - Country:US
Mailing Address - Phone:443-802-1117
Mailing Address - Fax:443-708-2991
Practice Address - Street 1:3140 LEEDS ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-3817
Practice Address - Country:US
Practice Address - Phone:443-802-1117
Practice Address - Fax:443-708-2991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-19
Last Update Date:2021-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility