Organization
REACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEATHER JOHNSON (EXECUTIVE DIRECTOR)
(207) 838-2772
Entity
Organization
Contact information
Practice address
347 MADISON AVE, SUITE A, SKOWHEGAN, ME 04976-4238
(207) 612-6618
Mailing address
PO BOX 990, SKOWHEGAN, ME 04976-0990
(207) 612-6618
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
681564
ME
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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