Organization
COMMUNITY CORRECTIONAL ALTERNATIVES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM S. TANNER PH.D. (PRESIDENT)
(207) 872-4500
Entity
Organization
Contact information
Practice address
15 COLLEGE AVE, WATERVILLE, ME 04901-6104
(207) 872-4500
(207) 872-2441
Mailing address
15 COLLEGE AVE, WATERVILLE, ME 04901-6104
(207) 872-4500
(207) 872-2441
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
414950
ME
251S00000X
Community/Behavioral Health Agency
Primary
414950
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
170230000
—
ME
Enumeration date
10/26/2006
Last updated
06/21/2018
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