Provider Demographics
NPI:1205193174
Name:NFI NORTH: DIRIGO PLACE
Entity Type:Organization
Organization Name:NFI NORTH: DIRIGO PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:1603-746-7550
Mailing Address - Street 1:PO BOX 417
Mailing Address - Street 2:
Mailing Address - City:CONTOOCOOK
Mailing Address - State:NH
Mailing Address - Zip Code:03229-0417
Mailing Address - Country:US
Mailing Address - Phone:160-374-6755
Mailing Address - Fax:160-374-6754
Practice Address - Street 1:98 RUSSELL ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6004
Practice Address - Country:US
Practice Address - Phone:120-778-4714
Practice Address - Fax:120-778-4591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEXL3650251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health