Individual
MARTHA M COURSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
867 SHERMAN ST, ISLAND FALLS, ME 04747-4413
(207) 463-2757
Mailing address
867 SHERMAN ST, ISLAND FALLS, ME 04747-4413
(207) 463-2757
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
216650000
—
ME
Enumeration date
07/07/2009
Last updated
07/07/2009
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