Healthcare Provider Details

I. General information

NPI: 1174398812
Provider Name (Legal Business Name): GHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2023
Last Update Date: 11/22/2023
Certification Date: 11/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 HOLLAND ST
HOULTON ME
04730-1706
US

IV. Provider business mailing address

93 MILITARY ST
HOULTON ME
04730-2497
US

V. Phone/Fax

Practice location:
  • Phone: 207-532-6593
  • Fax: 207-532-4456
Mailing address:
  • Phone: 207-538-6593
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JAMES WAYNE BROWN
Title or Position: OWNER
Credential:
Phone: 207-532-6593