Basic Information
| Provider Information | |||||||||
| NPI: | 1265433486 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | CARE & COMFORT | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 180 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049016666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078725300 | ||||||||
| FaxNumber: | 2078736612 | ||||||||
| Practice Location | |||||||||
| Address1: | 180 MAIN ST | ||||||||
| Address2: | |||||||||
| City: | WATERVILLE | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049016666 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2078725300 | ||||||||
| FaxNumber: | 2078736612 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/10/2005 | ||||||||
| LastUpdateDate: | 11/15/2011 | ||||||||
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| AuthorizedOfficialLastName: | GIGUERE | ||||||||
| AuthorizedOfficialFirstName: | SUSAN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2078725300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.