St. John Valley Foster Home

NPI #1508007592 in Van Buren, Maine

Provider Information

NPI Number: 1508007592
Entity Type: Organization
Organization Name: St. John Valley Foster Home
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Mar 20, 2009
Last Updated: Mar 20, 2009

Practice Location

Address: 122 CHURCH STREET
City: Van Buren
State: Maine
ZIP Code: 04785-1446
Phone: (207) 868-2243

Authorized Official

Name: MRS. SHARON L GAGNON
Title: FOSTER HOME OPERATOR
Phone: (207) 868-2243

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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