Organization
ST JUDE'S FOSTER HOME
Active
Other names
Judy Gagnon
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY D GAGNON (FOSTER HOME OPERATOR)
(207) 868-5180
Entity
Organization
Contact information
Practice address
123 WRIGHT STREET, VON BUREN, ME 04785
(207) 868-5180
(207) 868-7781
Mailing address
123 WRIGHT STREET, VON BUREN, ME 04785
(207) 868-5180
(207) 868-7781
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197470000
—
ME
Enumeration date
03/06/2009
Last updated
03/06/2009
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