Provider Demographics
NPI:1154538254
Name:YORK COUNTY COMMUNITY ACTION CORPORATION
Entity type:Organization
Organization Name:YORK COUNTY COMMUNITY ACTION CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LAURENDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-324-5762
Mailing Address - Street 1:6 SPRUCE ST
Mailing Address - Street 2:P.O. BOX 72
Mailing Address - City:SANFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04073-2917
Mailing Address - Country:US
Mailing Address - Phone:207-324-5762
Mailing Address - Fax:207-490-5026
Practice Address - Street 1:6 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-2917
Practice Address - Country:US
Practice Address - Phone:207-324-5762
Practice Address - Fax:207-490-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347B00000XTransportation ServicesBus
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME137930100Medicaid