Provider Demographics
NPI:1225406614
Name:YORK COUNTY COMMUNITY ACTION CORP
Entity Type:Organization
Organization Name:YORK COUNTY COMMUNITY ACTION CORP
Other - Org Name:NASSON HEALTH CARE-MBH-BIDDEFORD
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURENDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-324-5762
Mailing Address - Street 1:6 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-2917
Mailing Address - Country:US
Mailing Address - Phone:207-324-5762
Mailing Address - Fax:207-490-5026
Practice Address - Street 1:2 SPRINGBROOK DR
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9443
Practice Address - Country:US
Practice Address - Phone:207-490-6900
Practice Address - Fax:207-324-0546
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-02
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME000216073Medicaid
ME000216073Medicaid