Provider Demographics
NPI:1164625752
Name:SPRAGUE, ERIKA RHODES
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:RHODES
Last Name:SPRAGUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 334
Mailing Address - Street 2:19 WILSON HILL ROAD
Mailing Address - City:CHERRYFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04622-0334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:19 WILSON HILL RD
Practice Address - Street 2:
Practice Address - City:CHERRYFIELD
Practice Address - State:ME
Practice Address - Zip Code:04622-4435
Practice Address - Country:US
Practice Address - Phone:207-460-1291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities