Organization
DEXTER BOARDING HOME
Active
Parent organization
RAYMOND H BISHOP
Organization subpart
Yes
Provider details
NPI number
Legal business name
RAYMOND H BISHOP
Authorized official
RAYMOND H BISHOP (OWNER)
(207) 924-6211
Entity
Organization
Contact information
Practice address
45 MAIN ST, DEXTER, ME 04930-1267
(207) 924-6211
(207) 924-7406
Mailing address
45 MAIN ST, DEXTER, ME 04930-1267
(207) 924-6211
(207) 924-7406
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
ALLS 2748
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103580000
—
ME
Enumeration date
04/24/2009
Last updated
04/24/2009
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