Provider Demographics
NPI:1083905749
Name:PEOPLES COMMUNITY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:PEOPLES COMMUNITY HEALTH CENTER, INC
Other - Org Name:PEOPLE'S HEALTH AT WOMEN'S HOUSING COALITION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:CASSATT
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:410-467-6040
Mailing Address - Street 1:2524 KIRK AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-4826
Mailing Address - Country:US
Mailing Address - Phone:410-467-6040
Mailing Address - Fax:
Practice Address - Street 1:14 E FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2211
Practice Address - Country:US
Practice Address - Phone:410-467-6040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD910561100Medicaid
MD910561100Medicaid