Healthcare Provider Details

I. General information

NPI: 1174767784
Provider Name (Legal Business Name): HEALTHY FUTURES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 MAIN ST. SUITE A
WINTHROP ME
04364-1406
US

IV. Provider business mailing address

72 MAIN ST. SUITE A.
WINTHROP ME
04364-1406
US

V. Phone/Fax

Practice location:
  • Phone: 207-377-5377
  • Fax: 207-377-5379
Mailing address:
  • Phone: 207-377-5377
  • Fax: 207-377-5379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. REBECCA WEST DICK
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 207-377-5377