Anne M Bourque
Individual provider Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · West Gardiner, ME
NPI 1487987558 · NPPES record last updated Sep 8, 2009
Key facts
- NPI
- 1487987558
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
- Practice address
- 22 Ledge Hill Way
West Gardiner, ME 04345-3135 - Phone
- (207) 582-3146
- NPI assigned
- Sep 8, 2009
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | Yes |
Addresses
Primary practice location
22 Ledge Hill Way
West Gardiner, ME 04345-3135
Mailing address
22 Ledge Hill Way
West Gardiner, ME 04345-3135
Phone (207) 582-3146
Other providers in West Gardiner, ME
- Michael Dennis Aitken
- Counsel Me Maine
- Michael Dalton
- Michelle Lynne Levesque
- Gracelyn Maguire
- Kelsie-Lynne Newton
All providers in West Gardiner, ME · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.