MEDICARE: SOCIAL SIGNIFICANCE

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	251B00000X	Case Management Agency
2	103K00000X	Behavior Analyst	1-15-18247	ME

General Provider Information

NPI Number	:	1578930244
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOCIAL SIGNIFICANCE

Provider Business Mailing Address
First Line	:	7 VICTORIA LN
Second Line	:
City	:	NORTH WATERBORO
State	:	ME
Zip	:	04061-4741
Country	:	US
Telephone Number	:	207-712-4554
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 VICTORIA LN
Second Line	:
City	:	NORTH WATERBORO
State	:	ME
Zip	:	04061-4741
Country	:	US
Telephone Number	:	207-712-4554
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR/OWNER
Name	:	MR. TIMOTHY JOHN FOLLEY
Credential	:	BCBA
Telephone Number	:	207-712-4554

Provider Enumeration Date	:	08/28/2015
Last Update Date	:	09/01/2015

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Directions to “SOCIAL SIGNIFICANCE ” Practice Location

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