Organization
WOTTON WAIVER HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BONNIE M WOTTON (WAIVER HOME PROVIDER)
(207) 538-9652
Entity
Organization
Contact information
Practice address
232 WOTTON ROAD, MONTICELLO, ME 04760-0125
(207) 538-9652
Mailing address
PO BOX 125, MONTICELLO, ME 04760-0125
(207) 538-9652
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
196370000
—
ME
Enumeration date
05/06/2009
Last updated
05/06/2009
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