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General NPI Number Information
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NPI Number | 1306413315
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Entity Type | Organization
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Legal Business Name | ASSOCIATED CATHOLIC CHARITIES, INC
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Dates
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Enumeration Date | 06/08/2021
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 2 N DUNDALK AVE
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City | DUNDALK
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State | MD
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Zip | 21222-4221
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Country | US
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Telephone | 667-600-3681
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Fax | 667-600-4093
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Provider Business Mailing Address
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Address Line | 308 VIRGINIA AVE
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City | CUMBERLAND
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State | MD
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Zip | 21502-4559
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Country | US
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Telephone | 667-600-2118
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Fax |
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Authorized Official
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Title or Position | REGIONAL DIRECTOR
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Name | LISA ANN SERFASS
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Credential | LCPC
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Telephone | 667-600-2118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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