Organization
AMICUS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEIDI R GODSOE (EXECUTIVE DIRECTOR)
(207) 941-2892
Entity
Organization
Contact information
Practice address
96 13TH ST, BANGOR, ME 04401-4538
(207) 941-2892
(207) 941-2888
Mailing address
96 THIRTEENTH STREET, BANGOR, ME 04401
(207) 941-2892
(207) 941-2888
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
431573400
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E55026
SALES TAX EXEMPTION
ME
Enumeration date
02/13/2007
Last updated
06/10/2011
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