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General NPI Number Information
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NPI Number | 1831325968
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Entity Type | Organization
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Legal Business Name | RAFTS INC
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 75 WEST MAIN STREET
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City | GREENE
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State | ME
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Zip | 04236
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Country | US
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Telephone | 207-784-6995
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Fax | 207-784-2398
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Provider Business Mailing Address
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Address Line | 47 WOOD ST
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City | LEWISTON
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State | ME
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Zip | 04240-6844
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Country | US
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Telephone | 207-784-6995
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Fax | 207-784-2398
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. HAROLD STROUT
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Credential |
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Telephone | 207-784-6995
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number | ALLS 2873
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License Number State | ME
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