Provider Demographics
NPI:1568794790
Name:ANDERSONS COMMUNITY HEALTHCARE SERVICES INC
Entity Type:Organization
Organization Name:ANDERSONS COMMUNITY HEALTHCARE SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/DIRECTOR OF NURSING
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ELVIRIA
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:240-643-0441
Mailing Address - Street 1:4727 VERDANA LOOP
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703
Mailing Address - Country:US
Mailing Address - Phone:240-643-0441
Mailing Address - Fax:866-827-3870
Practice Address - Street 1:4727 VERDANA LOOP
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703
Practice Address - Country:US
Practice Address - Phone:240-643-0441
Practice Address - Fax:866-827-3870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-15
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR156712163WC0400X, 251B00000X, 251C00000X, 251S00000X
DCRN1004478251B00000X, 251C00000X, 251J00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No163WC0400XNursing Service ProvidersRegistered NurseCase ManagementGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty