Organization
BRADLEY D. LANPHERE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY D LANPHERE (OWNER)
(207) 596-7495
Entity
Organization
Contact information
Practice address
30 KIMBERLY DRIVE, ROCKPORT, ME 04856-0404
(207) 596-7495
(207) 596-7495
Mailing address
PO BOX 404, ROCKPORT, ME 04856-0404
(207) 596-7495
(207) 596-7495
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/02/2009
Last updated
02/02/2009
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