Provider Demographics
NPI:1629382726
Name:MAKING THE IMPOSSIBLE POSSIBLE CASE MANAGEMENT
Entity Type:Organization
Organization Name:MAKING THE IMPOSSIBLE POSSIBLE CASE MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:WITHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MHRT-C
Authorized Official - Phone:207-217-6711
Mailing Address - Street 1:273 HAMMOND ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4610
Mailing Address - Country:US
Mailing Address - Phone:207-217-6711
Mailing Address - Fax:207-217-6712
Practice Address - Street 1:273 HAMMOND ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4610
Practice Address - Country:US
Practice Address - Phone:207-217-6711
Practice Address - Fax:207-217-6712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management