Organization
CRESCENT CITIES CHARITIES INC
Active
Other names
Crescent Cities Center
Organization subpart
No
Provider details
NPI number
Authorized official
BETSY GODBEY (SECRETARY)
(301) 567-7076
Entity
Organization
Contact information
Practice address
4409 E WEST HWY, RIVERDALE, MD 20737-1058
(301) 699-2000
(301) 699-7786
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4436
(610) 925-4351
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
16ALA53
MD
314000000X
Skilled Nursing Facility
Primary
16-039
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022S
CAREFIRST - PROV/INQ#
—
05
—
088101500
—
MD
01
—
2197479
AETNA-HMO
—
01
—
276684
UNITED - MAMSI
—
01
—
53957
AMERIGROUP
—
01
—
71-00483
UNITED - EVERCARE
—
01
—
HV2
CAREFIRST BLUECHOICE
—
Enumeration date
05/25/2006
Last updated
06/21/2018
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