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General NPI Number Information
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NPI Number | 1154993863
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Entity Type | Organization
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Legal Business Name | COMMUNITY CHOICE BEHAVIORAL HEALTH, LLC.
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Dates
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Enumeration Date | 07/13/2021
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 110 MAIN ST STE 1509
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City | SACO
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State | ME
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Zip | 04072-3517
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Country | US
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Telephone | 207-640-4400
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Fax | 207-640-4474
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Provider Business Mailing Address
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Address Line | 110 MAIN ST STE 1509
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City | SACO
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State | ME
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Zip | 04072-3517
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Country | US
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Telephone | 207-640-4400
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Fax | 207-640-4474
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ANNA SKRZYPEK
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Credential | MSW, MHRT/C
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Telephone | 708-928-0587
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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