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STACEY R GIBBS
NPI 1417764580
Assisted Living Facility in Baltimore, MD

Active since December 12, 2024
3609 E NORTHERN PKWY, BALTIMORE, MD 21206(443) 415-1409 Get Directions Write a Review

NPPES record last updated: December 12, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Stacey R Gibbs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STACEY R GIBBS (NPI 1417764580) is an individual assisted living facility provider in Baltimore, Maryland, licensed in Maryland (30AL3570-A) and active in the NPI registry since December 2024.

NPPES Registry Identity

NPI1417764580
Entity TypeIndividualFemale
Primary Taxonomy310400000X
Provider Legal NameSTACEY R GIBBS
Location Address3609 E NORTHERN PKWYBaltimore, MD 21206-1645
Mailing Address3609 E Northern PkwyBaltimore, MD 21206-1645 · (443) 415-1409
Phone(443) 415-1409
Sole ProprietorYes
Enumeration DateDecember 12, 2024
NPPES CertifiedDecember 12, 2024
✔ NPI 1417764580 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
License✔ Licensed in MD · 30AL3570-A
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
3609 E NORTHERN PKWY, Baltimore, MD 21206
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Stacey Gibbs's NPI number?

The NPI number for Stacey Gibbs is 1417764580. It was assigned to this individual provider in the NPPES registry on December 12, 2024.

Where is Stacey Gibbs located?

Stacey Gibbs practices at 3609 E Northern Pkwy, Baltimore, MD 21206. The listed phone number is (443) 415-1409.

What is Stacey Gibbs's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Stacey Gibbs was last updated on December 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.