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General NPI Number Information
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NPI Number | 1568435345
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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 | 02/10/2006
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Last Update Date | 11/10/2014
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Provider Practice Location Address
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Address Line | 32 RAILROAD ST
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City | BETHEL
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State | ME
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Zip | 04217-1367
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Country | US
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Telephone | 207-824-2193
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Fax | 207-824-3138
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Provider Business Mailing Address
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Address Line | PO BOX 1367 32 RAILROAD ST
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City | BETHEL
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State | ME
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Zip | 04217-1367
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Country | US
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Telephone | 207-824-2193
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Fax | 207-824-3138
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | CONSTANCE R COGGINS
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Credential |
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Telephone | 207-872-5610
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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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