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Organization
PIERCE RESIDENTIAL CARE
Active
Organization
PIERCE RESIDENTIAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILLIP E PIERCE JR. (FOSTER HOME PROVIDER)
(207) 843-0724
Entity
Organization
Contact information
Practice address
24 ROCK RIDGE RD, DEDHAM, ME 04429
(207) 843-0724
Mailing address
PO BOX 314, HOLDEN, ME 04429
(207) 843-0724
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
ALLS 3008
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1D 208240000
—
ME
Enumeration date
04/21/2009
Last updated
09/10/2009
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