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General NPI Number Information
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NPI Number | 1184410292
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Entity Type | Organization
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Legal Business Name | THE TOWN FARM
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/16/2025
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Provider Practice Location Address
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Address Line | 344 ROUTE 202
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City | GREENE
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State | ME
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Zip | 04236-4208
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Country | US
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Telephone | 207-754-9234
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Fax |
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Provider Business Mailing Address
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Address Line | 249 MERROW RD
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City | AUBURN
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State | ME
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Zip | 04210-8319
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Country | US
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Telephone | 207-754-9234
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PETER BOLDUC JR.
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Credential |
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Telephone | 207-754-9234
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3245S0500X
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Taxonomy Name | Children's Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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