1013955947 NPI number — CATHOLIC CHARITIES MAINE

Table of content: (NPI 1013955947)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013955947 NPI number — CATHOLIC CHARITIES MAINE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CATHOLIC CHARITIES MAINE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1013955947
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10660
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PORTLAND
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04104-6060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-781-8550
Provider Business Mailing Address Fax Number:
207-781-8560

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
307 CONGRESS STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04101-3638
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-781-8550
Provider Business Practice Location Address Fax Number:
207-781-8560
Provider Enumeration Date:
06/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SCOTT
Authorized Official First Name:
LAURIE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CONTRACTER
Authorized Official Telephone Number:
207-781-8550

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YS0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TB0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 104100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041S0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 124Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 126800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 104200104 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200115 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200106 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200205 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200101 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200204 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200207 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200208 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200301 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200100 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200105 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200107 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200102 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200200 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200103 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200202 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200203 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 104200300 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".




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