# BRUCE GREEN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154550556
- **Authorized official:** BRUCE GREEN (OWNER)
- **Authorized official phone:** (207) 942-1902

## Contact information

- **Practice address:** 201 HUSSON AVE APT D2, BANGOR, ME 04401-3238
- **Practice address phone:** (207) 942-1902
- **Mailing address:** 201 HUSSON AVE APT D2, BANGOR, ME 04401-3238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 07/07/2009
- **Last updated:** 07/07/2009