Provider Demographics
NPI:1578997201
Name:SPANISH AMERICAN CIVIC ASSOCIATION FOR EQUALITY
Entity Type:Organization
Organization Name:SPANISH AMERICAN CIVIC ASSOCIATION FOR EQUALITY
Other - Org Name:CASA DEL PUENTE
Other - Org Type:Other Name
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WALKIRYA
Authorized Official - Middle Name:
Authorized Official - Last Name:PERALTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-431-1411
Mailing Address - Street 1:453 S LIME ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-3649
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:717-295-7762
Practice Address - Street 1:445 E KING ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3004
Practice Address - Country:US
Practice Address - Phone:717-431-1435
Practice Address - Fax:717-295-7762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility