Provider Demographics
NPI:1043537178
Name:CHILD DEVELOPMENT SERVICES
Entity Type:Organization
Organization Name:CHILD DEVELOPMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:G
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-623-4989
Mailing Address - Street 1:263 WATER ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-4609
Mailing Address - Country:US
Mailing Address - Phone:207-623-4989
Mailing Address - Fax:207-622-9798
Practice Address - Street 1:263 WATER ST
Practice Address - Street 2:SUITE 500
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-4609
Practice Address - Country:US
Practice Address - Phone:207-623-4989
Practice Address - Fax:207-622-9798
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-29
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEME283716252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME165660200Medicaid