Healthcare Provider Details

I. General information

NPI: 1992944540
Provider Name (Legal Business Name): BELFAST AREA CHILD CARE SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 WALDO AVE
BELFAST ME
04915-6615
US

IV. Provider business mailing address

1025 WATERVILLE RD
WALDO ME
04915-3113
US

V. Phone/Fax

Practice location:
  • Phone: 207-338-1751
  • Fax: 207-338-1751
Mailing address:
  • Phone: 207-342-5535
  • Fax: 207-342-2124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: BARBARA R KENNEDY
Title or Position: EXECUTIVE DIRECTOR/DEV.THERAPIST
Credential:
Phone: 207-342-5535