MEDICARE: YORK COUNTY COMMUNITY ACTION CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	347B00000X	Bus

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154538254
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YORK COUNTY COMMUNITY ACTION CORPORATION

Provider Business Mailing Address
First Line	:	6 SPRUCE ST
Second Line	:	P.O. BOX 72
City	:	SANFORD
State	:	ME
Zip	:	04073-2917
Country	:	US
Telephone Number	:	207-324-5762
Fax Number	:	207-490-5026

Provider Business Practice Location Address
First Line	:	6 SPRUCE ST
Second Line	:
City	:	SANFORD
State	:	ME
Zip	:	04073-2917
Country	:	US
Telephone Number	:	207-324-5762
Fax Number	:	207-490-5027

Authorized Official
Title or Position	:	CFO
Name	:	MS. DIANE LAURENDEAU
Credential	:
Telephone Number	:	207-324-5762

Provider Enumeration Date	:	05/17/2007
Last Update Date	:	07/02/2009

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Directions to “YORK COUNTY COMMUNITY ACTION CORPORATION ” Practice Location

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