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Contact Information

PREBLE STREET
52 FREDRIC STREET
PORTLAND, ME04104
 Phone: 207-775-0026
 Fax: 207-842-3614
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Case Management

251B00000X
Indicates primary specialty

NPI Profile & details for PREBLE STREET

NPI Number 1578713897
LBN Legal business name PREBLE STREET
Authorized official MARK SWANN - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 Yes
Enumeration date 09/23/2008
Last updated 01/28/2025 - More than a year ago
Identifiers
ME Medicaid 431576201
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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