Provider Demographics
NPI:1881831329
Name:WINGS FOR CHILDREN AND FAMILIES INC.
Entity Type:Organization
Organization Name:WINGS FOR CHILDREN AND FAMILIES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:NIEDOROWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-941-2988
Mailing Address - Street 1:900 HAMMOND ST
Mailing Address - Street 2:SUITE 915
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4378
Mailing Address - Country:US
Mailing Address - Phone:207-941-2988
Mailing Address - Fax:207-941-2989
Practice Address - Street 1:900 HAMMOND ST
Practice Address - Street 2:SUITE 915
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4378
Practice Address - Country:US
Practice Address - Phone:207-941-2988
Practice Address - Fax:207-941-2989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-20
Last Update Date:2009-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME237567261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME128520000Medicaid