Organization
GREEN VALLEY ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC C. QUINT (EXECUTIVE DIRECTOR)
(207) 436-2156
Entity
Organization
Contact information
Practice address
69 DAVID ST, ISLAND FALLS, ME 04765
(207) 463-2156
(207) 463-2151
Mailing address
PO BOX 127, ISLAND FALLS, ME 04747-0127
(207) 463-2156
(207) 463-2151
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104300100
—
ME
Enumeration date
12/26/2006
Last updated
12/22/2009
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