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General NPI Number Information
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NPI Number | 1336636216
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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 | 04/17/2018
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Last Update Date | 04/17/2018
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Provider Practice Location Address
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Address Line | 1220 E JOPPA RD STE 332
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City | BALTIMORE
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State | MD
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Zip | 21286-5811
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Country | US
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Telephone | 667-600-2331
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Fax |
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Provider Business Mailing Address
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Address Line | 1966 GREENSPRING DR STE 200
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City | TIMONIUM
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State | MD
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Zip | 21093-4164
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Country | US
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Telephone | 667-600-2244
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | GLORIA OVERSMITH
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Credential |
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Telephone | 667-600-2249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number |
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License Number State | MD
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