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Individual

PAUL CHARTRAND

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
369 WESTSIDE ROAD, ADDISON, ME 04606-0017
(207) 483-6604
Mailing address
PO BOX 17, ADDISON, ME 04606-0017
(207) 483-6604

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
ALLS 1379
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
144760000
ME
05
215480001
ME
Enumeration date
01/05/2007
Last updated
05/05/2009
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