Dawn Ouellette

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Eagle Lake, ME

NPI 1184867590 · NPPES record last updated Apr 15, 2009

Key facts

NPI
1184867590
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
DAWN OUELLETTE
Practice address
13 South Brook Lane
Eagle Lake, ME 04739
Phone
(207) 444-4562
Fax
(207) 444-4069
NPI assigned
Apr 15, 2009
Organization subpart
No

Authorized official

Name
Dawn M Ouellette
Title
Home Provider
Phone
(207) 444-4562

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

13 South Brook Lane
Eagle Lake, ME 04739

Mailing address

13 South Brook Lane
Eagle Lake, ME 04739
Phone (207) 444-4562

Other identifiers

IdentifierTypeStateIssuer
202220000MedicaidME

Other providers in Eagle Lake, ME

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

Sources for this page

Verify at the official NPI Registry.