=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619811072
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RIVERVIEW RESIDENTIAL SUPPORT
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/16/2026
-----------------------------------------------------
Last Update Date | 04/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2 RIVERVIEW LANE
-----------------------------------------------------
City | ADDISON
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04606
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-598-6979
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 146
-----------------------------------------------------
City | ADDISON
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04606-0146
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-598-6979
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | CHRISTOPHER CHARTRAND
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 207-598-6979
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------