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General NPI Number Information
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NPI Number | 1245546456
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Entity Type | Organization
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Legal Business Name | BECKET FAMILY OF SERVICES
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Dates
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Enumeration Date | 08/25/2010
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Last Update Date | 08/25/2010
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Provider Practice Location Address
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Address Line | 744 OAKLAND RD
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City | BELGRADE
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State | ME
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Zip | 04917-3411
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Country | US
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Telephone | 207-465-7985
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Fax | 207-465-7184
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Provider Business Mailing Address
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Address Line | PO BOX 269
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City | BELGRADE
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State | ME
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Zip | 04917-0269
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Country | US
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Telephone | 207-465-7985
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Fax | 207-465-7184
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. JENNIFER FULLERTON
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Credential | LCSW
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Telephone | 207-465-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | ME
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