Organization
CITY OF FREDERICK
Active
Other names
Frederick Community Action Agency
Organization subpart
No
Provider details
NPI number
Authorized official
RAMENTA COTTRELL (DIRECTOR)
(301) 600-3955
Entity
Organization
Contact information
Practice address
100 S MARKET ST, FREDERICK, MD 21701-5527
(301) 600-1506
Mailing address
100 S MARKET ST, FREDERICK, MD 21701-5527
(301) 600-1506
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200175600
—
MD
01
—
21D0885241
CLIA
MD
Enumeration date
03/13/2017
Last updated
11/02/2021
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