Provider Demographics
NPI:1376599308
Name:HEALTH CARE FOR CHILDREN,LLC
Entity Type:Organization
Organization Name:HEALTH CARE FOR CHILDREN,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:LOPEZ
Authorized Official - Last Name:DALIVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-398-8899
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21922-0309
Mailing Address - Country:US
Mailing Address - Phone:410-398-8899
Mailing Address - Fax:410-398-1477
Practice Address - Street 1:215 NORTH ST STE A
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5505
Practice Address - Country:US
Practice Address - Phone:410-398-8899
Practice Address - Fax:410-398-1477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-25
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD274CHEOtherCAREFIRST GROUP NUMBER
MD409020900Medicaid