Provider Demographics
NPI:1700010824
Name:BILLIE'S ADULT RESIDENTIAL CARE HOME P.A.
Entity Type:Organization
Organization Name:BILLIE'S ADULT RESIDENTIAL CARE HOME P.A.
Other - Org Name:BILLIE'S ARCH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BILLIE JO
Authorized Official - Middle Name:
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-532-3952
Mailing Address - Street 1:8 LEONARD ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-1708
Mailing Address - Country:US
Mailing Address - Phone:207-532-3952
Mailing Address - Fax:
Practice Address - Street 1:8 LEONARD ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-1708
Practice Address - Country:US
Practice Address - Phone:207-532-3952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS3514311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME431976200Medicaid