Provider Demographics
NPI:1225899909
Name:UNION COMMUNITY CARE
Entity type:Organization
Organization Name:UNION COMMUNITY CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:ALISA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-945-1551
Mailing Address - Street 1:454 NEW HOLLAND AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2290
Mailing Address - Country:US
Mailing Address - Phone:717-299-6371
Mailing Address - Fax:717-325-8057
Practice Address - Street 1:711 S 8TH ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-6750
Practice Address - Country:US
Practice Address - Phone:717-299-6371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNION COMMUNITY CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-19
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1007614190026Medicaid