Provider Demographics
NPI:1477781490
Name:CARLA OLIVER
Entity Type:Organization
Organization Name:CARLA OLIVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-612-9311
Mailing Address - Street 1:182 CHICKEN ST
Mailing Address - Street 2:
Mailing Address - City:STARKS
Mailing Address - State:ME
Mailing Address - Zip Code:04911-4427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:182 CHICKEN ST
Practice Address - Street 2:
Practice Address - City:STARKS
Practice Address - State:ME
Practice Address - Zip Code:04911-4427
Practice Address - Country:US
Practice Address - Phone:207-612-9311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-29
Last Update Date:2009-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care