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Organization
NANCY J. MITCHELL HOME TRUST
Active
Organization
NANCY J. MITCHELL HOME TRUST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL G MITCHELL (TRUSTEE)
(207) 827-6688
Entity
Organization
Contact information
Practice address
1 SANDY BEACH LANE, INDIAN ISLAND, ME 04468
(207) 827-6688
Mailing address
PO BOX 1381, BANGOR, ME 04402-1381
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
126500000
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
53161131A
—
ME
Enumeration date
01/31/2007
Last updated
07/22/2008
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