Healthcare Provider Details

I. General information

NPI: 1568794790
Provider Name (Legal Business Name): ANDERSONS COMMUNITY HEALTHCARE SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2010
Last Update Date: 08/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4727 VERDANA LOOP
FREDERICK MD
21703
US

IV. Provider business mailing address

4727 VERDANA LOOP
FREDERICK MD
21703
US

V. Phone/Fax

Practice location:
  • Phone: 240-643-0441
  • Fax: 866-827-3870
Mailing address:
  • Phone: 240-643-0441
  • Fax: 866-827-3870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR156712
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberR156712
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberRN1004478
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberR156712
License Number StateMD
# 5
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberRN1004478
License Number StateDC
# 6
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberRN1004478
License Number StateDC
# 7
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberR156712
License Number StateMD
# 8
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberRN1004478
License Number StateDC

VIII. Authorized Official

Name: MRS. ELIZABETH ELVIRIA ANDERSON
Title or Position: CEO/DIRECTOR OF NURSING
Credential: R.N., BSN
Phone: 240-643-0441