DataLabs

datalabs.health made in the usa

Contact us Sign in | Documentation |

divider

Medicare/Medicaid Verification Programs divider

divider

Medicare Verification Program divider

divider

1407802010

NPI Code Detail

MEDICARE: CRESCENT CITIES CHARITIES INC

MEDICARE: CRESCENT CITIES CHARITIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	16ALA53	MD
2	314000000X	Skilled Nursing Facility	16-039	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2197479	OTHER		AETNA-HMO
2	53957	OTHER		AMERIGROUP
3	HV2	OTHER		CAREFIRST BLUECHOICE
4	022S	OTHER		CAREFIRST - PROV/INQ#
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	276684	OTHER		UNITED - MAMSI
7	71-00483	OTHER		UNITED - EVERCARE
8	HV2	OTHER		CAREFIRST - IND/PPO

General Provider Information

NPI Number	:	1407802010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CRESCENT CITIES CHARITIES INC

Provider Business Mailing Address
First Line	:	101 E STATE ST
Second Line	:
City	:	KENNETT SQUARE
State	:	PA
Zip	:	19348-3109
Country	:	US
Telephone Number	:	610-925-4436
Fax Number	:	610-925-4351

Provider Business Practice Location Address
First Line	:	4409 E WEST HWY
Second Line	:
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1058
Country	:	US
Telephone Number	:	301-699-2000
Fax Number	:	301-699-7786

Authorized Official
Title or Position	:	SECRETARY
Name	:	BETSY GODBEY
Credential	:
Telephone Number	:	301-567-7076

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	06/21/2018

Similar Medicare Providers

1952259996 — M MANAGEMENT GROUP LLC
Practice Location Address:

4409 E WEST HWY
RIVERDALE, MD
20737-1058

Practice Phone: 301-699-2000
Practice Fax:

1699804344 — YVONNE NICOLE RUDDER M.D.
Practice Location Address:

4409 E WEST HWY
RIVERDALE, MD
20737-1058

Practice Phone: 703-359-7460
Practice Fax:

1730383738 — KIMBERLY STREET P.T.
Practice Location Address:

4409 E WEST HWY
RIVERDALE, MD
20737-1058

Practice Phone: 301-699-2000
Practice Fax:

1184828162 — MR. ELIZABETH MICHELE SHABAZZ PT
Practice Location Address:

4409 E WEST HWY
RIVERDALE, MD
20737-1058

Practice Phone: 301-699-2000
Practice Fax: 301-209-2976

1598962839 — MRS. JUNE ELAINE BROWN DAVIS OCCUPATIONAL THERAPI
Practice Location Address:

4409 E WEST HWY
RIVERDALE, MD
20737-1058

Practice Phone: 301-699-2000
Practice Fax:

1366635625 — TRACY ANNE BRYAN-OLIVER P.T.
Practice Location Address:

4409 E WEST HWY
RIVERDALE, MD
20737-1058

Practice Phone: 301-985-3221
Practice Fax:

Directions to “CRESCENT CITIES CHARITIES INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.