Provider Demographics
NPI:1942301650
Name:PARTNERSHIP FOR HEALTH, HEALING & COMMUNITY
Entity Type:Organization
Organization Name:PARTNERSHIP FOR HEALTH, HEALING & COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORTON STANFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-571-3095
Mailing Address - Street 1:342 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-1516
Mailing Address - Country:US
Mailing Address - Phone:207-571-3095
Mailing Address - Fax:207-571-3097
Practice Address - Street 1:342 MAIN ST
Practice Address - Street 2:
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072-1516
Practice Address - Country:US
Practice Address - Phone:207-571-3095
Practice Address - Fax:207-571-3097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME1420811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMO ME 1347Medicare ID - Type Unspecified