Organization
RESIDENTIAL AND COMMUNITY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE TIERNAN (PROGRAM DIRECTOR)
(207) 432-5343
Entity
Organization
Contact information
Practice address
78A MADISON ST, NORTH BERWICK, ME 03906-6734
(207) 432-5343
Mailing address
78A MADISON ST, NORTH BERWICK, ME 03906-6734
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
ME
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
ME
Other
Enumeration date
11/04/2013
Last updated
11/04/2013
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