Provider Demographics
NPI:1851539548
Name:CHILD HEALTH CENTER
Entity Type:Organization
Organization Name:CHILD HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:R
Authorized Official - Last Name:HATCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-743-7035
Mailing Address - Street 1:16 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04270-3579
Mailing Address - Country:US
Mailing Address - Phone:207-743-7035
Mailing Address - Fax:207-743-2970
Practice Address - Street 1:16 MADISON AVE
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:ME
Practice Address - Zip Code:04270-3579
Practice Address - Country:US
Practice Address - Phone:207-743-7035
Practice Address - Fax:207-743-2970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME210451252Y00000X, 261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No252Y00000XAgenciesEarly Intervention Provider Agency