COMMUNITY CLINICAL SERVICES, INC. (NPI# 1417301623) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417301623 |
| Entity Type | Organization |
| Organization Name | COMMUNITY CLINICAL SERVICES, INC. |
| Other Organization Name | CCS BEHAVIORAL AT POLAND |
| Practice Address |
1230 Maine St Room A Poland ME 04274-7325 |
| Mailing Address |
Po Box 95000 Lbx 7660 Philadelphia PA 19195-0001 |
| Practice Telephone | 2079984483 |
| Practice Fax Number | 2079982189 |
| Mailing Telephone | 2077778208 |
| Mailing Fax Number | 2077836660 |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2020-10-22 |
| Authorized Official Name | COLEEN L ELIAS (CEO/CFO) |
| Authorized Official Telephone | 2075133897 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY CLINICAL SERVICES, INC. |
| 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 |
|---|---|
| CCS Behavioral at Poland | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477909810 | Community Clinical Services, Inc. | Clinic/Center | 15 Sacred Heart Pl, Room A, Auburn, ME 04210-4938 | 2016-05-04 |
| 1720371313 | Community Clinical Services, Inc. | Clinic/Center | 96 Campus Ave, Suite 218, Lewiston, ME 04240-6019 | 2011-05-16 |
| 1710279344 | Community Clinical Services, Inc. | Clinic/Center | 100 Campus Ave Ste 208, Lewiston, ME 04240-6069 | 2011-05-16 |
| 1164477568 | Community Clinical Services, Inc. | Family Medicine | 57 Birch St Ste 102, Lewiston, ME 04240-7415 | 2006-05-23 |
| 1336590207 | Community Clinical Services, Inc. | Clinic/Center | 198 Main St, Room A, Lewiston, ME 04240-7074 | 2016-06-22 |
| 1942655345 | Community Clinical Services, Inc. | Clinic/Center | 15 Mollison Way, Room A, Lewiston, ME 04240-5805 | 2016-05-04 |
| 1346695756 | Community Clinical Services, Inc. | Clinic/Center | 3 Willow Run, Room A, Auburn, ME 04210-8501 | 2016-05-04 |
| 1760836977 | Community Clinical Services, Inc. | Clinic/Center | 99 Campus Ave, Suite 201, Room A, Lewiston, ME 04240-6045 | 2016-04-14 |
| 1821442039 | Community Clinical Services, Inc. | Clinic/Center | 2 Great Falls Plz, Suite 21, Room A, Auburn, ME 04210-5966 | 2016-04-14 |
| 1740649227 | Community Clinical Services, Inc. | Clinic/Center | 330 Sabattus St, Suite B, Lewiston, ME 04240-5553 | 2016-02-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY CLINICAL SERVICES, INC. | B St Community Ctr 57 Birch St Ste 201, Lewiston, ME 04240 |
| Street Address |
1230 MAINE ST ROOM A |
| City | POLAND |
| State | ME |
| Zip Code | 04274-7325 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619991320 | Douglas G Smith | Family Medicine | 1230 Maine St, Poland, ME 04274-7325 | 2006-07-26 |
| 1881149250 | Jessica Langella | Registered Nurse | 1230 Maine St, Poland, ME 04274-7325 | 2016-08-16 |
| 1093061418 | Jordan A Albair | Nurse Practitioner | 1230 Maine St, Poland, ME 04274 | 2012-08-03 |
| 1235369620 | Julie A Wilson | Nurse Practitioner | 1230 Maine St, Poland, ME 04274-7325 | 2009-07-20 |
| 1326211582 | Basem Mohamed Elbrolosy | Family Medicine | 1230 Maine St, Poland, ME 04274-7325 | 2008-04-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225204134 | Jessica N Weary | Social Worker | 1203 Maine St., Poland, ME 04274 | 2008-05-01 |
| 1942289657 | Trisha Gushue | Family Medicine | 364 Maine St, Poland, ME 04274-5109 | 2006-01-11 |
| 1699322859 | Christopher Raymond Butler | Nurse Practitioner | 364 Maine St, Poland, ME 04274-5109 | 2019-08-22 |
| 1821168469 | James Frederick Weigand | Dentist | 364 Maine St, Poland Spring, ME 04274-5109 | 2006-11-09 |
| 1770528143 | Nathan Raby | Family Medicine | 364 Maine St, Poland, ME 04274-5109 | 2006-06-18 |
| 1215917943 | Dana Little | Family Medicine | 364 Maine St, Poland, ME 04274-5109 | 2006-01-19 |
| 1790020543 | Deborah Susan Housley | Dental Hygienist | 9 Doten Ln, Poland, ME 04274-5605 | 2012-12-05 |
| 1699931899 | Kristen Gree Cobb | Specialist | 211 Range Hill Rd, Poland, ME 04274-5901 | 2008-08-06 |
| 1083224679 | Theresa Louise Allocca | Counselor | 96 Birch Dr, Poland Spring, ME 04274-6115 | 2020-08-07 |
| 1194966002 | Dorothy Margaret Maroon | Dental Hygienist | 12 Lafrinea Ln, Poland, ME 04274-6158 | 2009-03-23 |
| Find all providers in zip 04274 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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|---|---|---|---|---|
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| 1295386316 | Community Clinical Services, Inc | Clinic/Center | 1250 Turner St, Auburn, ME 04210-6436 | 2019-09-20 |
| 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 |
| 1760973960 | Penobscot Community Health Center | Clinic/Center | 1012 Union St Ste 3, Bangor, ME 04401-3058 | 2018-05-23 |
| 1700317971 | Portland Community Health Center | Clinic/Center | 28 Portland St, Portland, ME 04101-2912 | 2017-03-21 |
| 1184165367 | Katahdin Valley Health Center | Clinic/Center | 65 South St, Houlton, ME 04730-1550 | 2017-03-20 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.