Organization
CCM-4U, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIMBERLY MARIE BOUTILIER (CO-OWNER)
(207) 262-9799
Entity
Organization
Contact information
Practice address
611 HAMMOND ST, BANGOR, ME 04401-4571
(207) 262-9799
(207) 262-9662
Mailing address
PO BOX 752, BANGOR, ME 04402-0752
(207) 262-9799
(207) 262-9662
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
11/16/2022
Last updated
11/16/2022
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