Organization
CHARLOTTE WHITE CENTER
Active
Other names
FSD Adult
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICHARD M BROWN (CEO)
(207) 564-2464
Entity
Organization
Contact information
Practice address
572 BANGOR RD, DOVER FOXCROFT, ME 04426
(207) 564-2464
(207) 564-2404
Mailing address
572 BANGOR RD, DOVER FOXCROFT, ME 04426
(207) 564-2464
(207) 564-2404
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164840200
—
ME
Enumeration date
11/27/2006
Last updated
11/12/2008
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