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General NPI Number Information
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NPI Number | 1992939656
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Entity Type | Organization
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Legal Business Name | HC WATSON
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Dates
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Enumeration Date | 05/11/2009
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Last Update Date | 05/11/2009
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Provider Practice Location Address
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Address Line | 72 ATLANTIC PL
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2316
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Country | US
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Telephone | 207-775-3366
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Fax | 207-775-3366
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Provider Business Mailing Address
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Address Line | 72 ATLANTIC PL
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2316
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Country | US
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Telephone | 207-775-3366
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Fax | 207-775-3366
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Authorized Official
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Title or Position | REGIONAL AREA MANAGER
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Name | MRS. ANGLEA SPENCER
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Credential | R.N
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Telephone | 207-775-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 02929
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 2948
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License Number State | ME
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