Provider Demographics
NPI:1568847663
Name:ASHLEY, INC
Entity Type:Organization
Organization Name:ASHLEY, INC
Other - Org Name:ASHLEY PROFESSIONAL SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:VP FINANCE/CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GERMANN
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:410-273-2207
Mailing Address - Street 1:800 TYDINGS LN
Mailing Address - Street 2:
Mailing Address - City:HAVRE DE GRACE
Mailing Address - State:MD
Mailing Address - Zip Code:21078-2102
Mailing Address - Country:US
Mailing Address - Phone:800-799-4673
Mailing Address - Fax:410-273-2290
Practice Address - Street 1:800 TYDINGS LN
Practice Address - Street 2:
Practice Address - City:HAVRE DE GRACE
Practice Address - State:MD
Practice Address - Zip Code:21078-2102
Practice Address - Country:US
Practice Address - Phone:800-799-4673
Practice Address - Fax:410-273-2290
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHLEY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-07-30
Last Update Date:2016-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD125005100Medicaid