MEDICARE: MRS. LINDA E ASHBY C.N.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	ALLS1433	ME

General Provider Information

NPI Number	:	1134275001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LINDA E ASHBY C.N.A.

Provider Business Mailing Address
First Line	:	284 E RIVER RD
Second Line	:
City	:	PEMBROKE
State	:	ME
Zip	:	04666-4408
Country	:	US
Telephone Number	:	207-726-9528
Fax Number	:	207-726-9528

Provider Business Practice Location Address
First Line	:	284 E RIVER RD
Second Line	:
City	:	PEMBROKE
State	:	ME
Zip	:	04666-4408
Country	:	US
Telephone Number	:	207-726-9528
Fax Number	:	207-726-9528

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2007
Last Update Date	:	07/08/2007

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