Provider Demographics
NPI:1912137027
Name:MARION BAPTIST ASSOCIATION
Entity Type:Organization
Organization Name:MARION BAPTIST ASSOCIATION
Other - Org Name:CHRISTIAN COUNSELING ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:A
Authorized Official - Last Name:SALMERON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-622-6292
Mailing Address - Street 1:1520 NE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34470-4638
Mailing Address - Country:US
Mailing Address - Phone:352-622-6292
Mailing Address - Fax:352-622-8567
Practice Address - Street 1:1520 NE 14TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34470-4638
Practice Address - Country:US
Practice Address - Phone:352-622-6292
Practice Address - Fax:352-622-8567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-23
Last Update Date:2009-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty