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General NPI Number Information
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NPI Number | 1952898256
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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 | 04/23/2018
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 1118 LIGHT ST STE 200
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City | BALTIMORE
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State | MD
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Zip | 21230-4152
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Country | US
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Telephone | 667-600-2880
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Fax |
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Provider Business Mailing Address
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Address Line | 2300 DULANEY VALLEY RD
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City | TIMONIUM
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State | MD
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Zip | 21093-2739
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Country | US
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Telephone | 667-600-2249
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Fax | 667-600-4068
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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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