Organization
CONNECTIONS FOR KIDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GENEVIEVE GARDNER LCSW (EXECUTIVE DIRECTOR)
(207) 854-1030
Entity
Organization
Contact information
Practice address
100 GANNETT DR, SUITE A, SOUTH PORTLAND, ME 04106-5900
(207) 854-1030
(207) 854-1001
Mailing address
100 GANNETT DR, SUITE A, SOUTH PORTLAND, ME 04106-5900
(207) 854-1030
(207) 854-1001
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
559381
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128860004
—
ME
01
—
432955600
MEDICAID FAMILY BRIDGE PROGRAM
ME
05
—
432955600
—
ME
05
—
433455400
—
ME
05
—
433457000
—
ME
Enumeration date
09/24/2008
Last updated
01/26/2017
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