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General NPI Number Information
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NPI Number | 1588720866
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTH AND COUNSELING SERVICES
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Dates
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Enumeration Date | 12/29/2006
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Last Update Date | 11/23/2011
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Provider Practice Location Address
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Address Line | 42 CEDAR ST
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City | BANGOR
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State | ME
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Zip | 04402-0425
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Country | US
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Telephone | 207-947-0366
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Fax |
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Provider Business Mailing Address
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Address Line | 42 CEDAR ST PO BOX 425
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City | BANGOR
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State | ME
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Zip | 04402-0425
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Country | US
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Telephone | 207-947-0366
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DALE HAMILTON
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Credential |
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Telephone | 207-947-0366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 02790
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License Number State | ME
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