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General NPI Number Information
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NPI Number | 1447334479
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Entity Type | Organization
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Legal Business Name | PHILLIPS-STRICKLAND HOUSE
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 21 BOYD ST
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City | BANGOR
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State | ME
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Zip | 04401-6560
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Country | US
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Telephone | 207-941-2820
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Fax | 207-941-2829
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Provider Business Mailing Address
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Address Line | 21 BOYD ST
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City | BANGOR
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State | ME
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Zip | 04401-6560
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Country | US
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Telephone | 207-941-2820
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Fax | 207-941-2829
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | ANDREW CASSIDY
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Credential |
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Telephone | 207-941-2820
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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 | ALLS-1399
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License Number State | ME
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