Bradley D. Lanphere

NPI #1679711493 in Rockport, Maine

Provider Information

NPI Number: 1679711493
Entity Type: Organization
Organization Name: Bradley D. Lanphere
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Feb 2, 2009
Last Updated: Feb 2, 2009

Practice Location

Address: 30 KIMBERLY DRIVE
City: Rockport
State: Maine
ZIP Code: 04856-0404
Phone: (207) 596-7495

Authorized Official

Name: MR. BRADLEY D LANPHERE
Title: OWNER
Phone: (207) 596-7495

Specialties & Taxonomy Codes

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

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