Provider Demographics
NPI:1194088351
Name:SPANISH AMERICAN CIVIC ASSOCIATION FOR EQUITY, INC
Entity type:Organization
Organization Name:SPANISH AMERICAN CIVIC ASSOCIATION FOR EQUITY, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAUPERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-509-3712
Mailing Address - Street 1:545 PERSHING AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-4369
Mailing Address - Country:US
Mailing Address - Phone:717-293-4150
Mailing Address - Fax:
Practice Address - Street 1:453 S LIME ST
Practice Address - Street 2:SUITE A
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-3649
Practice Address - Country:US
Practice Address - Phone:717-431-1411
Practice Address - Fax:717-295-7762
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA329680261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health