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General NPI Number Information
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NPI Number | 1700060753
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Entity Type | Organization
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Legal Business Name | TEDFORD HOUSING
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 12/27/2007
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Provider Practice Location Address
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Address Line | 34 FEDERAL ST
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City | BRUNSWICK
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State | ME
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Zip | 04011-1522
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Country | US
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Telephone | 207-729-1161
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Fax | 207-725-7626
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Provider Business Mailing Address
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Address Line | PO BOX 958
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City | BRUNSWICK
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State | ME
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Zip | 04011-0958
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Country | US
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Telephone | 207-729-1161
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Fax | 207-725-7626
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DONALD L KNISELEY
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Credential |
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Telephone | 207-729-1161
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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