Provider Demographics
NPI:1912338906
Name:PILLARS COMMUNITY OUTREACH, INC.
Entity Type:Organization
Organization Name:PILLARS COMMUNITY OUTREACH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NETWORK ADMIN
Authorized Official - Prefix:MS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:I
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-453-4500
Mailing Address - Street 1:121 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04937-1528
Mailing Address - Country:US
Mailing Address - Phone:207-453-4500
Mailing Address - Fax:207-453-4502
Practice Address - Street 1:121 MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:ME
Practice Address - Zip Code:04937-1528
Practice Address - Country:US
Practice Address - Phone:207-453-4500
Practice Address - Fax:207-453-4502
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-02
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMHA673808251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME133360029Medicaid