Rae Ellen Snow

Individual provider Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Charleston, ME

NPI 1003962150 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1003962150
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
License
ALLS 1363 (ME)
Practice address
21 Bacon Rd
Charleston, ME 04422-3212
Phone
(207) 285-3842
NPI assigned
Jan 25, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
ALLS 1363MEMDIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X ALLS 1363 ME Yes

Addresses

Primary practice location

21 Bacon Rd
Charleston, ME 04422-3212

Mailing address

21 Bacon Rd
Charleston, ME 04422-3212
Phone (207) 285-3842

Other providers in Charleston, ME

All providers in Charleston, ME · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine

Sources for this page

Verify at the official NPI Registry.