Provider Demographics
NPI:1740340132
Name:WOODFORDS FAMILY SERVICES
Entity type:Organization
Organization Name:WOODFORDS FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:
Authorized Official - Last Name:THIBODEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-878-9663
Mailing Address - Street 1:15 SAUNDERS WAY STE 900
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04092-4836
Mailing Address - Country:US
Mailing Address - Phone:207-878-9663
Mailing Address - Fax:207-878-2259
Practice Address - Street 1:15 SAUNDERS WAY STE 700
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4834
Practice Address - Country:US
Practice Address - Phone:207-878-9663
Practice Address - Fax:207-878-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME494640251S00000X
252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431775100Medicaid
ME104090303Medicaid
ME104090302Medicaid
ME104090400Medicaid
ME104090201Medicaid
ME104090401Medicaid
ME104090000Medicaid
ME104090100Medicaid
ME104090102Medicaid
ME104090200Medicaid