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Organization

SHAW HOUSE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CAROL WHITNEY (EXECUTIVE DIRECTOR)
(207) 941-2874
Entity
Organization

Contact information

Practice address
136 UNION ST, BANGOR, ME 04401-6327
(207) 941-2874
(207) 941-2875
Mailing address
136 UNION ST, BANGOR, ME 04401-6327
(207) 941-2874
(207) 941-2875

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
128120200
ME
Enumeration date
12/22/2009
Last updated
12/22/2009
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