Healthcare Provider Details

I. General information

NPI: 1265002125
Provider Name (Legal Business Name): CHRISTINES FOSTER HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 07/01/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 POPLAR ST
VAN BUREN ME
04785-1153
US

IV. Provider business mailing address

110 POPLAR ST
VAN BUREN ME
04785-1153
US

V. Phone/Fax

Practice location:
  • Phone: 207-868-3354
  • Fax: 207-868-3354
Mailing address:
  • Phone: 207-868-3354
  • Fax: 207-868-3354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE C LAPOINTE
Title or Position: OWNER
Credential:
Phone: 207-868-3354