Healthcare Provider Details

I. General information

NPI: 1154657401
Provider Name (Legal Business Name): RHONDA E. CHAMBERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2009
Last Update Date: 10/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 SOUTH ST
CALAIS ME
04619-1324
US

IV. Provider business mailing address

152 SOUTH ST
CALAIS ME
04619-1324
US

V. Phone/Fax

Practice location:
  • Phone: 207-454-8960
  • Fax: 207-454-8964
Mailing address:
  • Phone: 207-454-8960
  • Fax: 207-454-8964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MRS. RHONDA E CHAMBERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 207-454-2587