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NPI 1518196799

NPI 1518196799 : NICOLE FARLEY : WOODLAND, ME

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General NPI Number Information
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    NPI Number           |    1518196799
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    Entity Type          |    Organization 
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    Legal Business Name  |    NICOLE FARLEY 
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Dates
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    Enumeration Date     |    07/08/2009
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    Last Update Date     |    07/08/2009
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Provider Practice Location Address
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    Address Line         |    507 DAVIS RD 
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    City                 |    WOODLAND
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    State                |    ME
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    Zip                  |    04736-5331
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    Country              |    US
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    Telephone            |    207-455-4895
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    507 DAVIS RD 
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    City                 |    WOODLAND
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    State                |    ME
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    Zip                  |    04736-5331
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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                 |     NICOLE  FARLEY 
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    Credential           |    
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    Telephone            |    207-455-4895
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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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