Organization
MSAD1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY LEE WAUGH (ADMINISTRATIVE ASSISTANT)
(207) 764-3036
Entity
Organization
Contact information
Practice address
79 BLAKE ST, SUITE #1, PRESQUE ISLE, ME 04769-2474
(207) 764-3036
(207) 768-3445
Mailing address
79 BLAKE ST, SUITE #1, PRESQUE ISLE, ME 04769-2474
(207) 764-3036
(207) 768-3445
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
05/25/2007
Last updated
08/22/2020
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