Provider Demographics
NPI:1750514808
Name:MAINE OFFICE OF CHILD AND FAMILY SERVICES
Entity type:Organization
Organization Name:MAINE OFFICE OF CHILD AND FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCFS CHILD WELFARE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DESPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-624-7950
Mailing Address - Street 1:2 ANTHONY AVE
Mailing Address - Street 2:STATE HOUSE STATION #11
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-9426
Mailing Address - Country:US
Mailing Address - Phone:207-624-7900
Mailing Address - Fax:207-287-5282
Practice Address - Street 1:2 ANTHONY AVE
Practice Address - Street 2:STATE HOUSE STATION #11
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-9426
Practice Address - Country:US
Practice Address - Phone:207-624-7900
Practice Address - Fax:207-287-5282
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE OF MAINE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251B00000X, 253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency
No251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME999101781HMedicaid
ME135910301Medicaid