Organization
NORTH STAR FARM INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREL A PACE M.ED. (EXECUTIVE DIRECTOR)
(207) 793-6612
Entity
Organization
Contact information
Practice address
112 THYNGS MILL ROAD, NO WATERBORO, ME 04061
(207) 793-6612
Mailing address
PO BOX 54, N WATERBORO, ME 04061-0054
(207) 793-6612
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
400986
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424030000
—
ME
Enumeration date
01/13/2009
Last updated
01/13/2009
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