Organization
MAIN STREAM HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD A SMITH (ADMINISTRATOR)
(207) 683-2016
Entity
Organization
Contact information
Practice address
248 CAMBRIDGE RD, HARMONY, ME 04942-0008
(207) 683-2016
Mailing address
PO BOX 8, HARMONY, ME 04942-0008
(207) 683-2016
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
ALLS 3065
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215920000
—
ME
Enumeration date
05/19/2009
Last updated
05/19/2009
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