Organization
PREBLE STREET
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN YOUNG (HR SUPERVISOR)
(207) 874-1100
Entity
Organization
Contact information
Practice address
38 PREBLE ST, PORTLAND, ME 04101-4952
(207) 874-1100
Mailing address
38 PREBLE ST, PORTLAND, ME 04101-4952
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
LC15222
ME
Other
Enumeration date
06/13/2016
Last updated
06/13/2016
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