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General NPI Number Information
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NPI Number | 1265767081
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Entity Type | Organization
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Legal Business Name | THE FARMINGTON HOME FOR AGED PEOPLE, INC.
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Dates
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Enumeration Date | 10/13/2009
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Last Update Date | 10/13/2009
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Provider Practice Location Address
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Address Line | 204 MAIN ST
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City | FARMINGTON
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State | ME
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Zip | 04938-1901
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Country | US
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Telephone | 207-778-4745
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Fax | 207-778-5922
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Provider Business Mailing Address
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Address Line | 204 MAIN ST
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City | FARMINGTON
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State | ME
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Zip | 04938-1901
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Country | US
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Telephone | 207-778-4745
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Fax | 207-778-5922
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. DARLENE BEULAH MOOAR
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Credential | DTR
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Telephone | 207-778-4745
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ALLS3486
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License Number State | ME
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