Provider Demographics
NPI:1033447131
Name:LANGLEY VOCATIONAL SERVICES
Entity Type:Organization
Organization Name:LANGLEY VOCATIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:R
Authorized Official - Last Name:LANGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DSP
Authorized Official - Phone:207-873-0564
Mailing Address - Street 1:16 HOLLINGSWORTH ST
Mailing Address - Street 2:
Mailing Address - City:WINSLOW
Mailing Address - State:ME
Mailing Address - Zip Code:04901-6742
Mailing Address - Country:US
Mailing Address - Phone:207-873-0564
Mailing Address - Fax:207-873-0564
Practice Address - Street 1:16 HOLLINGSWORTH ST
Practice Address - Street 2:
Practice Address - City:WINSLOW
Practice Address - State:ME
Practice Address - Zip Code:04901-6742
Practice Address - Country:US
Practice Address - Phone:207-873-0564
Practice Address - Fax:207-873-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431611600Medicaid