Provider Demographics
NPI:1780673863
Name:MCCREADY FOUNDATION, INC
Entity Type:Organization
Organization Name:MCCREADY FOUNDATION, INC
Other - Org Name:ALICE BYRD TAWES NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PATIENT ACCOUNTS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:410-968-1200
Mailing Address - Street 1:201 HALL HWY
Mailing Address - Street 2:
Mailing Address - City:CRISFIELD
Mailing Address - State:MD
Mailing Address - Zip Code:21817-1237
Mailing Address - Country:US
Mailing Address - Phone:410-968-1200
Mailing Address - Fax:410-968-1025
Practice Address - Street 1:201 HALL HWY
Practice Address - Street 2:
Practice Address - City:CRISFIELD
Practice Address - State:MD
Practice Address - Zip Code:21817-1237
Practice Address - Country:US
Practice Address - Phone:410-968-1200
Practice Address - Fax:410-968-1025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19003313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD59002801OtherCAREFIRST BC/BS
MD198407100Medicaid
MF8OtherBLUE CROSS NCA
MD254232300Medicaid
MF8OtherBLUE CROSS NCA