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Individual

MRS. ROSA LEE KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
375 OAKFIELD SMYRNA RD, OAKFIELD, ME 04763-3033
(207) 757-8796
Mailing address
375 OAKFIELD SMYRNA RD, OAKFIELD, ME 04763-3033
(207) 757-8796

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
43279700
ME
Enumeration date
05/28/2009
Last updated
05/28/2009
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