Organization
BROADREACH FAMILY AND COMMUNITY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLAIR BRADSTREET (CFO)
(207) 338-2200
Entity
Organization
Contact information
Practice address
5 STEPHENSON LN, BELFAST, ME 04915-7230
(207) 338-2200
(207) 338-1652
Mailing address
5 STEPHENSON LN, BELFAST, ME 04915-7230
(207) 338-2200
(207) 338-1652
Taxonomy
Speciality
Code
Description
License number
State
251300000X
Local Education Agency (LEA)
Primary
403530
ME
251B00000X
Case Management Agency
—
ME
251C00000X
Developmentally Disabled Services Day Training Agency
—
ME
251S00000X
Community/Behavioral Health Agency
—
ME
252Y00000X
Early Intervention Provider Agency
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124270000
—
ME
05
—
124270100
—
ME
05
—
124270202
—
ME
Enumeration date
09/18/2007
Last updated
04/27/2009
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