Basic Information
| Provider Information | |||||||||
| NPI: | 1134892508 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATED CATHOLIC CHARITIES, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2300B DULANEY VALLEY RD | ||||||||
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| City: | TIMONIUM | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6676002249 | ||||||||
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| Practice Location | |||||||||
| Address1: | 725 FALLSWAY | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212024147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6676003400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2021 | ||||||||
| LastUpdateDate: | 07/30/2021 | ||||||||
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| AuthorizedOfficialLastName: | REEVES | ||||||||
| AuthorizedOfficialFirstName: | GLORIA | ||||||||
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| AuthorizedOfficialTitleorPosition: | A/R, BILLING, AND SYSTEMS MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6676002249 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 07/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0405X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.