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General NPI Number Information
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NPI Number | 1164496410
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Entity Type | Organization
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Legal Business Name | HEALTHREACH COMMUNITY HEALTH CENTERS
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 24 GARDINER ST
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City | RICHMOND
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State | ME
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Zip | 04357-1336
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Country | US
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Telephone | 207-737-4359
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Fax | 207-737-4412
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Provider Business Mailing Address
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Address Line | 24 GARDINER ST
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City | RICHMOND
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State | ME
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Zip | 04357-1336
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Country | US
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Telephone | 207-737-4359
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Fax | 207-737-4412
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Authorized Official
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Title or Position | INSURANCE CREDENTIALING COORDINATOR
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Name | KATE A QUIMBY
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Credential |
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Telephone | 207-864-2699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number | E58728
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License Number State | ME
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