MEDICARE: YORK COUNTY COMMUNITY ACTION CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1659580942
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YORK COUNTY COMMUNITY ACTION CORP

Provider Business Mailing Address
First Line	:	6 SPRUCE ST
Second Line	:	P.O. BOX 72
City	:	SANFORD
State	:	ME
Zip	:	04073-2917
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 SPRUCE ST
Second Line	:
City	:	SANFORD
State	:	ME
Zip	:	04073-2917
Country	:	US
Telephone Number	:	207-324-5762
Fax Number	:

Authorized Official
Title or Position	:	C.F.O
Name	:	DIANE LAURENDEAU
Credential	:
Telephone Number	:	207-324-5762

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	06/30/2009

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Directions to “YORK COUNTY COMMUNITY ACTION CORP ” Practice Location

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