Organization
RITA M WHITE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA M WHITE (OWNER)
(207) 895-3732
Entity
Organization
Contact information
Practice address
925 LAKE SHORE ROAD, SAINT DAVID, ME 04773
(207) 895-3732
Mailing address
925 LAKE SHORE ROAD, SAINT DAVID, ME 04773
(207) 895-3732
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
—
200180000
—
ME
Enumeration date
05/29/2009
Last updated
05/29/2009
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