Provider Demographics
NPI:1730323205
Name:TWO RIVERS CHILD DEVELOPMENT SERVICES
Entity Type:Organization
Organization Name:TWO RIVERS CHILD DEVELOPMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-564-3115
Mailing Address - Street 1:PO BOX 326
Mailing Address - Street 2:
Mailing Address - City:DOVER FOXCROFT
Mailing Address - State:ME
Mailing Address - Zip Code:04426
Mailing Address - Country:US
Mailing Address - Phone:207-564-3115
Mailing Address - Fax:207-564-0019
Practice Address - Street 1:1092A DOUTY HILL ROAD
Practice Address - Street 2:
Practice Address - City:DOVER FOXCROFT
Practice Address - State:ME
Practice Address - Zip Code:04426
Practice Address - Country:US
Practice Address - Phone:207-564-3115
Practice Address - Fax:207-564-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty