=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649412602
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WORK FIRST, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/06/2009
-----------------------------------------------------
Last Update Date | 04/06/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 309 WILTON ROAD 309 WILTON ROAD
-----------------------------------------------------
City | FARMINGTON
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-778-3200
-----------------------------------------------------
Fax | 207-778-4632
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 309 WILTON ROAD PO BOX 86
-----------------------------------------------------
City | FARMINGTON
-----------------------------------------------------
State | ME
-----------------------------------------------------
Zip | 04938
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 207-778-3200
-----------------------------------------------------
Fax | 207-778-4632
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EXECUTIVE DIRECTOR
-----------------------------------------------------
Name | LINDA LARUE-KENISTON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 207-778-3200
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------