| NPI | 1912108168 |
|---|---|
| Doing Business As | KENNEDY WAIVER HOME |
| Entity Type | Organization |
| Authorized Contact | REYNOLD RAYMOND Chief Executive Officer 207-444-5152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: ME ALLS 2226) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2020-08-22 |