Healthcare Provider Details

I. General information

NPI: 1528489358
Provider Name (Legal Business Name): HOLCOMB ASSOCIATES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2013
Last Update Date: 09/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 BRIDGE STREET
ELKTON MD
21921
US

IV. Provider business mailing address

467 CREAMERY WAY
EXTON PA
19341-2508
US

V. Phone/Fax

Practice location:
  • Phone: 410-398-4060
  • Fax: 410-398-8893
Mailing address:
  • Phone: 610-363-1488
  • Fax: 610-363-8273

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: TERESA JACKSON
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 610-363-1488