Healthcare Provider Details

I. General information

NPI: 1275774804
Provider Name (Legal Business Name): COMMUNITY REHABILITATION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/11/2009
Last Update Date: 03/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 MAINE AVE STE. 1A
FARMINGDALE ME
04344-2903
US

IV. Provider business mailing address

484 MAINE AVE STE. 1A
FARMINGDALE ME
04344-2903
US

V. Phone/Fax

Practice location:
  • Phone: 207-582-5577
  • Fax: 207-582-3208
Mailing address:
  • Phone: 207-582-5577
  • Fax: 207-582-3208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIE A. DYER
Title or Position: CEO
Credential:
Phone: 207-582-5577