Organization
CONSTANCE JONES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CONSTANCE JONES (HOME-BASE WAIVER PROVIDER)
(207) 633-5070
Entity
Organization
Contact information
Practice address
2 WATERFRONT LN N, BOOTHBAY, ME 04537-4438
(207) 633-5070
Mailing address
2 WATERFRONT LN N, BOOTHBAY, ME 04537-4438
(207) 633-5070
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431985500
—
ME
Enumeration date
09/15/2009
Last updated
09/24/2013
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