Organization
PREBLE STREET
Active
Organization
PREBLE STREET
Active
Parent organization
PREBLE STREET
Other names
Preble Street - Logan Place
Organization subpart
Yes
Provider details
NPI number
Legal business name
PREBLE STREET
Authorized official
MARK SWANN (EXECUTIVE DIRECTOR)
(207) 775-0026
Entity
Organization
Contact information
Practice address
52 FREDRIC STREET, PORTLAND, ME 04104
(207) 775-0026
(207) 842-3614
Mailing address
55 PORTLAND ST, PORTLAND, ME 04101-2921
(207) 775-0026
(207) 842-3614
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431576201
—
ME
Enumeration date
09/23/2008
Last updated
01/28/2025
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