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CONSTANCE JONES

Residential Treatment Mental Retardation

Boothbay, Maine

Provider NPI: 1144553777

Organization Information:
Organization Name:  CONSTANCE JONES
Organization is not Subpart
Authorized Official:  CONSTANCE  JONES  HOME-BASE WAIVER PROVIDER  207-6335070

Practice Location:
2 WATERFRONT LN N  BOOTHBAY, ME 04537 US
Tel: 207-633-5070  Fax: --

Business Mailing Address:
2 WATERFRONT LN N  BOOTHBAY, ME 04537 US
Tel: 207-633-5070  Fax: --

Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y320600000XResidential Treatment Facilities
Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities

Other Provider Identifiers:

IssuerNumberStateType
431985500ME05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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