Organization Name: | COMMUNITY CLINICAL SERVICES, INC. |
NPI Number: | 1023475134 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CAROLYN M KASABIAN (TREASURER) |
Mailing Address: | 330 Sabattus St Suite B Lewiston |
State: | ME US |
Postal Code: | 042405553 |
Phone Number: | 2077553160 |
Fax Number: | 2077553166 |
NPI Enumeration Date: | 01/20/2016 |
NPI Last Update Date: | 01/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QF0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
Taxonomy Definition: |