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General NPI Number Information
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NPI Number | 1487883989
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Entity Type | Organization
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Legal Business Name | LINDA RECKTENWALD
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 07/07/2009
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Provider Practice Location Address
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Address Line | 132 STREAM RD
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City | VIENNA
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State | ME
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Zip | 04360-3011
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Country | US
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Telephone | 207-293-2127
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 17
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City | FARMINGTON FALLS
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State | ME
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Zip | 04940-0017
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LINDA RECKTENWALD
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Credential |
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Telephone | 207-293-2127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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