Organization
FRANNIE PEABODY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICIA J CAPOUCH LCSW (EXECUTIVE DIRECTOR)
(207) 774-6877
Entity
Organization
Contact information
Practice address
335 VALLEY ST, PORTLAND, ME 04102-3010
(207) 774-6877
(207) 879-0761
Mailing address
335 VALLEY ST, PORTLAND, ME 04102-3010
(207) 774-6877
(207) 897-0761
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
19860461ND
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116750000
—
ME
Enumeration date
07/16/2009
Last updated
07/16/2009
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