Provider Demographics
NPI:1154500973
Name:YORK COUNTY SHELTER PROGRAMS INC
Entity Type:Organization
Organization Name:YORK COUNTY SHELTER PROGRAMS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:G
Authorized Official - Last Name:GERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-324-1137
Mailing Address - Street 1:24 GEORGE ST
Mailing Address - Street 2:
Mailing Address - City:ALFRED
Mailing Address - State:ME
Mailing Address - Zip Code:04002-3296
Mailing Address - Country:US
Mailing Address - Phone:207-324-1137
Mailing Address - Fax:207-324-5290
Practice Address - Street 1:147 SHAKER HILL ROAD
Practice Address - Street 2:
Practice Address - City:ALFRED
Practice Address - State:ME
Practice Address - Zip Code:04002-0820
Practice Address - Country:US
Practice Address - Phone:207-324-1137
Practice Address - Fax:207-324-5290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2017-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME109660600Medicaid