Organization
AMICUS
Active
Other names
Community Skills
Organization subpart
No
Provider details
NPI number
Authorized official
MS. HEIDI R GODSOE (EXECUTIVE DIRECTOR)
(207) 941-2892
Entity
Organization
Contact information
Practice address
96 13TH ST, SUITE 2, BANGOR, ME 04401-4538
(207) 941-2892
(207) 941-2888
Mailing address
96 13TH ST, SUITE 2, BANGOR, ME 04401-4538
(207) 941-2892
(207) 941-2888
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431573400
—
ME
Enumeration date
06/14/2011
Last updated
06/14/2011
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