Provider Demographics
NPI:1225230048
Name:PREVENTION PARTNERS INC
Entity Type:Organization
Organization Name:PREVENTION PARTNERS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WACHOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:RDH
Authorized Official - Phone:207-633-9716
Mailing Address - Street 1:448 WISCASSET RD
Mailing Address - Street 2:
Mailing Address - City:BOOTHBAY
Mailing Address - State:ME
Mailing Address - Zip Code:04537-4624
Mailing Address - Country:US
Mailing Address - Phone:207-633-9716
Mailing Address - Fax:207-633-2653
Practice Address - Street 1:448 WISCASSET RD
Practice Address - Street 2:
Practice Address - City:BOOTHBAY
Practice Address - State:ME
Practice Address - Zip Code:04537-4624
Practice Address - Country:US
Practice Address - Phone:207-633-9716
Practice Address - Fax:207-633-2653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0429124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty