Healthcare Provider Details

I. General information

NPI: 1629022645
Provider Name (Legal Business Name): RUMFORD GROUP HOMES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 04/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 KNOX ST
RUMFORD ME
04276-2212
US

IV. Provider business mailing address

160 LINCOLN AVE
RUMFORD ME
04276
US

V. Phone/Fax

Practice location:
  • Phone: 207-364-3551
  • Fax: 207-364-3544
Mailing address:
  • Phone: 207-364-3551
  • Fax: 207-364-3544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MELISSA A MCENTEE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 207-364-3551