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General NPI Number Information
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NPI Number | 1396975454
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Entity Type | Organization
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Legal Business Name | T.F.I.
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Dates
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Enumeration Date | 07/22/2009
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Last Update Date | 07/22/2009
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Provider Practice Location Address
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Address Line | 795 GARFIELD RD
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City | AUBURN
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State | ME
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Zip | 04210-8941
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Country | US
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Telephone | 207-754-1176
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Fax |
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Provider Business Mailing Address
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Address Line | 795 GARFIELD RD
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City | AUBURN
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State | ME
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Zip | 04210-8941
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Country | US
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Telephone | 207-754-1176
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CYNTHIA A. LEAVITT
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Credential | R.D.H.
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Telephone | 207-754-1176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 2552
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License Number State | ME
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