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General NPI Number Information
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NPI Number | 1629377544
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Entity Type | Organization
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Legal Business Name | EPIC DAYS
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Dates
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Enumeration Date | 03/17/2011
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 160 MAPLE ST
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City | BANGOR
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State | ME
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Zip | 04401-4032
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Country | US
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Telephone | 207-973-3742
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Fax | 207-973-3742
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Provider Business Mailing Address
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Address Line | 160 MAPLE ST
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City | BANGOR
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State | ME
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Zip | 04401-4032
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Country | US
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Telephone | 207-973-3742
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Fax | 207-973-3742
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Authorized Official
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Title or Position | ADMINISTRATOR/OWNER
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Name | MRS. KAREN LYNN CYR
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Credential | CRMA, DSP
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Telephone | 207-973-3742
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 373H00000X
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Taxonomy Name | Day Training/Habilitation Specialist
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License Number | ALLS 4255
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License Number State | ME
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