Provider Demographics
NPI:1275679243
Name:ASSOCIATED CATHOLIC CHARITIES
Entity Type:Organization
Organization Name:ASSOCIATED CATHOLIC CHARITIES
Other - Org Name:CARITAS HOUSE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIVISION DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-252-4005
Mailing Address - Street 1:3308 BENSON AVE.
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21227-1035
Mailing Address - Country:US
Mailing Address - Phone:410-646-6534
Mailing Address - Fax:410-646-6565
Practice Address - Street 1:3308 BENSON AVE.
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21227-1035
Practice Address - Country:US
Practice Address - Phone:410-646-6534
Practice Address - Fax:410-646-6565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2008-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30AL2546310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility