PORTLAND COMMUNITY HEALTH CENTER (NPI# 1184178246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184178246 |
| Entity Type | Organization |
| Organization Name | PORTLAND COMMUNITY HEALTH CENTER |
| Other Organization Name | CASCO BAY HIGH |
| Practice Address |
196 Allen Ave Portland ME 04103-3711 |
| Mailing Address |
180 Park Ave Portland ME 04102-2957 |
| Practice Telephone | 2078424693 |
| Mailing Telephone | 2078742141 |
| Enumeration Date | 2016-08-06 |
| Last Update Date | 2017-03-20 |
| Authorized Official Name | MS. ANN TUCKER (CFO) |
| Authorized Official Telephone | 20787420141 |
| Is Organization Subpart | Y |
| Parent Organization Name | PORTLAND COMMUNITY HEALTH CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Casco Bay High | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679047872 | Portland Community Health Center | Clinic/Center | 52 Frederic St, Portland, ME 04102-2700 | 2019-01-22 |
| 1043783822 | Portland Community Health Center | Clinic/Center | 72 Bishop St, Portland, ME 04102-2957 | 2019-01-04 |
| 1770056558 | Portland Community Health Center | Clinic/Center | 190 Valley Street, Portland, ME 04102-2957 | 2019-01-04 |
| 1700317971 | Portland Community Health Center | Clinic/Center | 28 Portland St, Portland, ME 04101-2912 | 2017-03-21 |
| 1255872537 | Portland Community Health Center | Clinic/Center | 175 Auburn St, Portland, ME 04103-2131 | 2017-03-20 |
| 1881135192 | Portland Community Health Center | Clinic/Center | 353 Cumberland Avenue, Cliff Island, ME 04109-0008 | 2017-03-20 |
| 1053719583 | Portland Community Health Center | Clinic/Center | 211 Cumberland Ave, Portland, ME 04101-4935 | 2014-12-16 |
| 1447694344 | Portland Community Health Center | Clinic/Center | 59 Riverton Dr, Portland, ME 04103-1050 | 2013-04-22 |
| 1073144622 | Portland Community Health Center | Clinic/Center | 125 Stroudwater St, Westbrook, ME 04092-4098 | 2020-02-03 |
| 1184165466 | Portland Community Health Center | Clinic/Center | 432 Stevens Ave, Portland, ME 04103-2607 | 2017-03-20 |
| Street Address |
196 ALLEN AVE |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103-3711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386762219 | Karen Scutt Potenziano | Social Worker | 196 Allen Ave, Casco Bay High School, Portland, ME 04103-3711 | 2007-03-27 |
| 1053682419 | Vicki Belinda Vadas | Physical Therapist | 196 Allen Ave, Portland, ME 04103-3711 | 2012-01-17 |
| 1750688750 | Elizabeth Babcock | Social Worker | 196 Allen Ave, Portland, ME 04103-3711 | 2011-02-28 |
| 1184926503 | Julie Ann Waterman | Health Educator | 196 Allen Ave, Portland, ME 04103-3711 | 2010-11-18 |
| 1154639540 | Portland Public Schools | Local Education Agency (LEA) | 196 Allen Ave, Portland, ME 04103-3711 | 2010-09-20 |
| 1366750853 | Monica J Hanson | Speech-Language Pathologist | 196 Allen Ave, Portland, ME 04103-3711 | 2010-09-17 |
| 1962719393 | Andrea Holloway Stamey | Speech-Language Pathologist | 196 Allen Ave, Portland, ME 04103-3711 | 2010-09-07 |
| 1306153903 | Jane Anderson | Occupational Therapist | 196 Allen Ave, Portland, ME 04103-3711 | 2010-09-03 |
| 1962719500 | Suzanne D'bourget | Speech-Language Pathologist | 196 Allen Ave, Portland, ME 04103-3711 | 2010-09-02 |
| 1821305442 | Tracey Anne Falla | Occupational Therapist | 196 Allen Ave, Portland, ME 04103-3711 | 2010-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679047872 | Portland Community Health Center | Clinic/Center | 52 Frederic St, Portland, ME 04102-2700 | 2019-01-22 |
| 1043783822 | Portland Community Health Center | Clinic/Center | 72 Bishop St, Portland, ME 04102-2957 | 2019-01-04 |
| 1770056558 | Portland Community Health Center | Clinic/Center | 190 Valley Street, Portland, ME 04102-2957 | 2019-01-04 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1700317971 | Portland Community Health Center | Clinic/Center | 28 Portland St, Portland, ME 04101-2912 | 2017-03-21 |
| 1255872537 | Portland Community Health Center | Clinic/Center | 175 Auburn St, Portland, ME 04103-2131 | 2017-03-20 |
| 1477005619 | Outside In | Clinic/Center | 1226 Sw 12th Ave, Portland, OR 97205-2029 | 2016-11-03 |
| 1649636986 | Mainline Health Systems, Inc | Clinic/Center | 314 Highway 160 E, Portland, AR 71663-9262 | 2015-12-31 |
| 1144691098 | Central City Concern Inc | Clinic/Center | 2566 Ne Hoyt St, Portland, OR 97232-2323 | 2015-10-16 |
| 1295119386 | Central City Concern Inc | Clinic/Center | 12133 E. Burnside St, Portland, OR 97216-2344 | 2015-07-17 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.