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General NPI Number Information
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NPI Number | 1407802010
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Entity Type | Organization
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Legal Business Name | CRESCENT CITIES CHARITIES INC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 4409 E WEST HWY
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City | RIVERDALE
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State | MD
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Zip | 20737-1058
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Country | US
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Telephone | 301-699-2000
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Fax | 301-699-7786
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Provider Business Mailing Address
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Address Line | 101 E STATE ST
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3109
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Country | US
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Telephone | 610-925-4436
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Fax | 610-925-4351
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Authorized Official
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Title or Position | SECRETARY
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Name | BETSY GODBEY
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Credential |
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Telephone | 301-567-7076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 16ALA53
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 16-039
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License Number State | MD
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