Organization
CHILDREN'S CENTER: EARLY INTERVENTION AND FAMILY SUPPORT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN H. LEACH (EXECUTIVE DIRECTOR)
(207) 626-3497
Entity
Organization
Contact information
Practice address
1 ALDEN AVE, AUGUSTA, ME 04330-6185
(207) 626-3497
(207) 621-6211
Mailing address
1 ALDEN AVE, AUGUSTA, ME 04330-6185
(207) 626-3497
(207) 621-6211
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103730000
—
ME
05
—
103730100
—
ME
05
—
103730200
—
ME
05
—
103730300
—
ME
05
—
103730400
—
ME
Enumeration date
02/26/2009
Last updated
02/26/2009
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