Provider Demographics
NPI:1043707342
Name:ASSOCIATED CATHOLIC CHARITIES, INC.
Entity type:Organization
Organization Name:ASSOCIATED CATHOLIC CHARITIES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OVERSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:667-600-2249
Mailing Address - Street 1:1966 GREENSPRING DR STE 200
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-4164
Mailing Address - Country:US
Mailing Address - Phone:667-600-2244
Mailing Address - Fax:
Practice Address - Street 1:606 CHERRY HILL RD STE 201
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21225-2055
Practice Address - Country:US
Practice Address - Phone:410-354-5101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health