YOUTH ALTERNATIVES INGRAHAM - NPI NUMBER 1326274622

Summary

Provider Name: YOUTH ALTERNATIVES INGRAHAM

NPI Number: 1326274622

Clasification: Case Management (251B00000X)

Address:
50 LYDIA LN
SOUTH PORTLAND, ME
ZIP 04106

Phone Number: (207) 874-1175



Detailed Information

YOUTH ALTERNATIVES INGRAHAM is a case management in South Portland, ME. The provider is an organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. The assigned NPI number for this provider is 1326274622 and is registered as an organization entity type.

The provider's business address is:

50 LYDIA LN
SOUTH PORTLAND, ME
ZIP 04106-156
Phone: (207) 874-1175
Fax: (207) 874-1181

The provider's authorized official is Virginia Gentile .
The authorized official title is Chief Financial Officer and has the following contact phone number (207) 874-1175.

The enumeration date for this NPI number is 6/2/2009 and was last updated on 3/23/2010.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 251B00000X Case Management Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 105460010 MEDICAID ME
2 105460005 MEDICAID ME
3 105460000 MEDICAID ME
4 105460011 MEDICAID ME
5 105460008 MEDICAID ME

NPI Record

No. Field Name Field Value
1 NPI 1326274622
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name YOUTH ALTERNATIVES INGRAHAM
5 Provider First Line Business Practice Location Address 50 LYDIA LN
6 Provider Business Practice Location Address City Name SOUTH PORTLAND
7 Provider Business Practice Location Address State Name ME
8 Provider Business Practice Location Address Postal Code 041062156
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 2078741175
11 Provider Business Practice Location Address Fax Number 2078741181
12 Provider Enumeration Date 6/2/2009
13 Last Update Date 3/23/2010
14 Authorized Official Last Name GENTILE
15 Authorized Official First Name VIRGINIA
16 Authorized Official Title or Position CHIEF FINANCIAL OFFICER
17 Authorized Official Telephone Number 2078741175
18 Healthcare Provider Taxonomy Code 1 251B00000X
19 Healthcare Provider Primary Taxonomy Switch 1 Y
20 Other Provider Identifier 1 105460010
21 Other Provider Identifier Type Code 1 05
22 Other Provider Identifier State 1 ME
23 Other Provider Identifier 2 105460005
24 Other Provider Identifier Type Code 2 05
25 Other Provider Identifier State 2 ME
26 Other Provider Identifier 3 105460000
27 Other Provider Identifier Type Code 3 05
28 Other Provider Identifier State 3 ME
29 Other Provider Identifier 4 105460011
30 Other Provider Identifier Type Code 4 05
31 Other Provider Identifier State 4 ME
32 Other Provider Identifier 5 105460008
33 Other Provider Identifier Type Code 5 05
34 Other Provider Identifier State 5 ME
35 Is Organization Subpart N

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.