Provider Demographics
NPI:1508157009
Name:WOODFORDS FAMILY SERVICES
Entity Type:Organization
Organization Name:WOODFORDS FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NAU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:207-878-9663
Mailing Address - Street 1:PO BOX 1768
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04104-1768
Mailing Address - Country:US
Mailing Address - Phone:207-878-9663
Mailing Address - Fax:
Practice Address - Street 1:15 SAUNDERS WAY
Practice Address - Street 2:900
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4833
Practice Address - Country:US
Practice Address - Phone:207-878-9663
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-02
Last Update Date:2011-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME494640251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1346483435Medicaid
ME1356584437Medicaid
ME1760704605OtherPHYSCOLOGICAL TESTING
ME1326281627OtherSPEECH
ME1619110798OtherCASE MANAGEMENT
ME1740340132OtherPRESCHOOL
ME1619110798Medicaid