Organization
YOUTH ALTERNATIVES INGRAHAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HAWLEY (FINANCIAL ANALYST)
(207) 874-1175
Entity
Organization
Contact information
Practice address
50 LYDIA LN, SOUTH PORTLAND, ME 04106-2156
(207) 874-1175
(207) 874-1181
Mailing address
50 LYDIA LN, SOUTH PORTLAND, ME 04106-2156
(207) 874-1175
(207) 874-1181
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
230741
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105460302
—
ME
Enumeration date
03/31/2010
Last updated
03/31/2010
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