MEDICARE: APPALACHIAN PARENT ASSOCIATION

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	251S00000X	Community/Behavioral Health Agency	12673	MD

General Provider Information

NPI Number	:	1558556977
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	APPALACHIAN PARENT ASSOCIATION

Provider Business Mailing Address
First Line	:	39 S 3RD ST
Second Line	:
City	:	OAKLAND
State	:	MD
Zip	:	21550-1522
Country	:	US
Telephone Number	:	301-334-8449
Fax Number	:	301-334-9633

Provider Business Practice Location Address
First Line	:	39 S 3RD ST
Second Line	:
City	:	OAKLAND
State	:	MD
Zip	:	21550-1522
Country	:	US
Telephone Number	:	301-334-8449
Fax Number	:	301-334-9633

Authorized Official
Title or Position	:	DIRECTOR DAY PROGRAMS
Name	:	SCOTT HOLLINGSWORTH
Credential	:
Telephone Number	:	301-334-8449

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	09/10/2007

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