Provider Demographics
NPI:1306413315
Name:ASSOCIATED CATHOLIC CHARITIES, INC
Entity Type:Organization
Organization Name:ASSOCIATED CATHOLIC CHARITIES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGIONAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SERFASS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:667-600-2118
Mailing Address - Street 1:308 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-4559
Mailing Address - Country:US
Mailing Address - Phone:667-600-2118
Mailing Address - Fax:
Practice Address - Street 1:2 N DUNDALK AVE
Practice Address - Street 2:
Practice Address - City:DUNDALK
Practice Address - State:MD
Practice Address - Zip Code:21222-4221
Practice Address - Country:US
Practice Address - Phone:667-600-3681
Practice Address - Fax:667-600-4093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)