Organization
SPRUCE RUN ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DORATHY MARTEL (GRANTS COORDINATOR)
(207) 945-5102
Entity
Organization
Contact information
Practice address
77 ESSEX ST, BANGOR, ME 04401-5301
(207) 945-5102
(207) 990-4252
Mailing address
PO BOX 653, BANGOR, ME 04402-0653
(207) 945-5102
(207) 990-4252
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432212700
—
ME
Enumeration date
04/26/2009
Last updated
04/26/2009
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