Provider Demographics
NPI:1639304454
Name:FAMILIES AND CHILDREN TOGETHER
Entity Type:Organization
Organization Name:FAMILIES AND CHILDREN TOGETHER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-941-2347
Mailing Address - Street 1:304 HANCOCK ST
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-6573
Mailing Address - Country:US
Mailing Address - Phone:207-941-2347
Mailing Address - Fax:207-941-9938
Practice Address - Street 1:304 HANCOCK ST
Practice Address - Street 2:SUITE 2B
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-6573
Practice Address - Country:US
Practice Address - Phone:207-941-2347
Practice Address - Fax:207-941-9938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-22
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME126060000Medicaid
ME432626000Medicaid