Providence Center, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

DDA-4049-00 Issued in MD

Legal business name

PROVIDENCE CENTER, INC.

Practice address

370 Shore Acres Rd
Arnold, MD 21012-2322

Phone

(410) 766-2212

Fax

(443) 577-0215

NPI assigned

May 3, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Charles E Coble Jr.

Title

Executive Director

Phone

(410) 766-2212

Specialties & licenses 1

Addresses

Tax ID family

Providence Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Providence Center, Inc.

  • Developmentally Disabled Services Day Training Agency
  • Millersville, MD
  • NPI 1801000955
  NPD tax ID

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194937292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 POINT PLEASANT RD",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210606604",
            "telephone_number": "410-766-2212",
            "fax_number": "443-577-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 SHORE ACRES RD",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122322",
            "telephone_number": "410-766-2212",
            "fax_number": "443-577-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "COBLE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-766-2212",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MD",
            "license": "DDA-4049-00",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Arnold, MD
• Providers in Arnold, MD by specialty
• Developmentally Disabled Services Day Training Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.