Provider Demographics
NPI:1003366899
Name:MCCREADY FOUNDATION INC
Entity Type:Organization
Organization Name:MCCREADY FOUNDATION INC
Other - Org Name:MCCREADY ADDICTION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REIMBURSEMENT SUPERVISOR
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-968-1029
Mailing Address - Street 1:201 HALL HWY
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817-1237
Mailing Address - Country:US
Mailing Address - Phone:410-968-1029
Mailing Address - Fax:410-968-1025
Practice Address - Street 1:201 HALL HWY
Practice Address - Street 2:
Practice Address - City:CRISFIELD
Practice Address - State:MD
Practice Address - Zip Code:21817-1237
Practice Address - Country:US
Practice Address - Phone:410-968-1029
Practice Address - Fax:410-968-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty