Healthcare Provider Details

I. General information

NPI: 1952509218
Provider Name (Legal Business Name): DORCHESTER COUNTY COMMISSION ON THE AGING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2007
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2474 CAMBRIDGE BELTWAY
CAMBRIDGE MD
21613-3679
US

IV. Provider business mailing address

2474 CAMBRIDGE BELTWAY
CAMBRIDGE MD
21613-3679
US

V. Phone/Fax

Practice location:
  • Phone: 410-228-0190
  • Fax: 410-221-8064
Mailing address:
  • Phone: 410-228-0190
  • Fax: 410-221-8064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JACKIE J VICKERS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 410-228-0190