Provider Demographics
NPI:1427407477
Name:E.C.C.O.
Entity Type:Organization
Organization Name:E.C.C.O.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIJAH
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-612-6308
Mailing Address - Street 1:12 CROSS ST
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-1810
Mailing Address - Country:US
Mailing Address - Phone:207-612-6308
Mailing Address - Fax:
Practice Address - Street 1:12 CROSS ST
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-1810
Practice Address - Country:US
Practice Address - Phone:207-612-6308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-10
Last Update Date:2020-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health