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Organization

TEEN AND YOUNG PARENT PROGRAM OF KNOX COUNTY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SANDRA LOWE (PRESIDENT OF THE BOARD OF DIRECTORS)
(207) 594-1980
Entity
Organization

Contact information

Practice address
231B PARK ST, ROCKLAND, ME 04841-2127
(207) 594-1980
(207) 594-7682
Mailing address
PO BOX 805, ROCKLAND, ME 04841-0805
(207) 594-1980
(207) 594-7682

Taxonomy

Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
432848100

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
432848100
MAINECARE PROVIDER ID
ME
Enumeration date
06/10/2009
Last updated
06/10/2009
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