Organization
GREEN VALLEY ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC C. QUINT (EXECUTIVE DIRECTOR)
(207) 463-2156
Entity
Organization
Contact information
Practice address
13 GARDNER STREET, PATTEN, ME 04765
(207) 528-2064
(207) 463-2151
Mailing address
PO BOX 127, ISLAND FALLS, ME 04747-0127
(207) 463-2156
(207) 463-2151
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
ALLS 2244
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104300300
—
ME
Enumeration date
01/29/2007
Last updated
01/12/2009
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