Organization
BONNIE RAE CONDON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONNIE RAE CONDON (CARE PROVIDER)
(207) 435-6726
Entity
Organization
Contact information
Practice address
3101 PORTAGE RD, PORTAGE LAKE, ME 04768-3111
(207) 435-6726
(207) 435-6949
Mailing address
3101 PORTAGE RD, PORTAGE LAKE, ME 04768-3111
(207) 435-6726
(207) 435-6949
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/06/2009
Last updated
03/06/2009
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