Healthcare Provider Details

I. General information

NPI: 1134275001
Provider Name (Legal Business Name): LINDA E ASHBY C.N.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

284 E RIVER RD
PEMBROKE ME
04666-4408
US

IV. Provider business mailing address

284 E RIVER RD
PEMBROKE ME
04666-4408
US

V. Phone/Fax

Practice location:
  • Phone: 207-726-9528
  • Fax: 207-726-9528
Mailing address:
  • Phone: 207-726-9528
  • Fax: 207-726-9528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License NumberALLS1433
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: