Provider Demographics
NPI:1821236134
Name:WESTERN MAINE COMMUNITY ACTION
Entity Type:Organization
Organization Name:WESTERN MAINE COMMUNITY ACTION
Other - Org Name:WMCA HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF FINANCE & ADMINISTRATIO
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:GERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-645-3764
Mailing Address - Street 1:21A CHURCH STREET
Mailing Address - Street 2:
Mailing Address - City:EAST WILTON
Mailing Address - State:ME
Mailing Address - Zip Code:04234
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:179 LISBON ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7248
Practice Address - Country:US
Practice Address - Phone:207-795-4007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-23
Last Update Date:2009-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical