Healthcare Provider Details

I. General information

NPI: 1023309721
Provider Name (Legal Business Name): LEARNINGWORKS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 04/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

181 BRACKETT ST
PORTLAND ME
04102-3857
US

IV. Provider business mailing address

181 BRACKETT ST
PORTLAND ME
04102-3857
US

V. Phone/Fax

Practice location:
  • Phone: 207-775-0105
  • Fax: 207-775-1392
Mailing address:
  • Phone: 207-775-0105
  • Fax: 207-775-1392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License NumberLC5063
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLC5063
License Number StateME

VIII. Authorized Official

Name: MR. ETHAN STRIMLING
Title or Position: CEO
Credential:
Phone: 207-775-0105