1801873989 NPI number — ASHLEY, INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801873989 NPI number — ASHLEY, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASHLEY, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
ASHLEY ADDICTION TREATMENT
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801873989
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 TYDINGS LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAVRE DE GRACE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21078-2102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-273-2213
Provider Business Mailing Address Fax Number:
410-344-2416

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
800 TYDINGS LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAVRE DE GRACE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21078-2132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-273-6600
Provider Business Practice Location Address Fax Number:
410-272-5617
Provider Enumeration Date:
12/29/2005

Additional Information

Authorized Official

Authorized Official Last Name:
BURGESS
Authorized Official First Name:
JIM
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT OF FINANCE
Authorized Official Telephone Number:
410-273-2319

Provider Taxonomy Codes

  • Taxonomy code: 324500000X , with the licence number:  13906 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 003653 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: NE7 . This is a "GHMSI" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 57595101 . This is a "CAREFIRST OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: A159250 . This is a "BLUE CROSS OF DELAWARE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 068274 . This is a "BLUE CROSS VIRGINIA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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