Organization
FAIRMOUNT BOARDING HOME
Active
Parent organization
RAYMOND H BISHOP
Organization subpart
Yes
Provider details
NPI number
Legal business name
RAYMOND H BISHOP
Authorized official
RAYMOND H BISHOP (OWNER)
(207) 924-6211
Entity
Organization
Contact information
Practice address
8 13TH ST, BANGOR, ME 04401-4538
(207) 942-5816
(207) 942-2701
Mailing address
8 13TH ST, BANGOR, ME 04401-4538
(207) 942-5816
(207) 942-2701
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
ALLS 3363
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103580001
—
ME
Enumeration date
04/24/2009
Last updated
04/27/2009
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