Healthcare Provider Details

I. General information

NPI: 1568581882
Provider Name (Legal Business Name): CHILDREN, FAMILIES AND COMMUNITIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 MAIN ST STE. A
ELLSWORTH ME
04605-1919
US

IV. Provider business mailing address

102 MAIN ST STE. A
ELLSWORTH ME
04605-1919
US

V. Phone/Fax

Practice location:
  • Phone: 207-667-6783
  • Fax: 207-667-0668
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: STACEY PAGNOZZI
Title or Position: OFFICE MANAGER
Credential:
Phone: 207-667-6783