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General NPI Number Information
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NPI Number | 1043537178
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Entity Type | Organization
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Legal Business Name | CHILD DEVELOPMENT SERVICES
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Dates
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Enumeration Date | 04/29/2010
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Last Update Date | 04/29/2010
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Provider Practice Location Address
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Address Line | 263 WATER ST SUITE 500
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City | AUGUSTA
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State | ME
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Zip | 04330-4609
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Country | US
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Telephone | 207-623-4989
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Fax | 207-622-9798
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Provider Business Mailing Address
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Address Line | 263 WATER ST SUITE 500
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City | AUGUSTA
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State | ME
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Zip | 04330-4609
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Country | US
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Telephone | 207-623-4989
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Fax | 207-622-9798
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Authorized Official
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Title or Position | DIRECTOR
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Name | DEBORAH G DUNN
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Credential |
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Telephone | 207-623-4989
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | ME283716
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License Number State | ME
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