Healthcare Provider Details

I. General information

NPI: 1831325968
Provider Name (Legal Business Name): RAFTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2009
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 WEST MAIN STREET
GREENE ME
04236
US

IV. Provider business mailing address

47 WOOD ST
LEWISTON ME
04240-6844
US

V. Phone/Fax

Practice location:
  • Phone: 207-784-6995
  • Fax: 207-784-2398
Mailing address:
  • Phone: 207-784-6995
  • Fax: 207-784-2398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License NumberALLS 2873
License Number StateME

VIII. Authorized Official

Name: MR. HAROLD STROUT
Title or Position: ADMINISTRATOR
Credential:
Phone: 207-784-6995