Provider Demographics
NPI:1760610513
Name:MILLICENT CLAPP
Entity Type:Organization
Organization Name:MILLICENT CLAPP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILLICENT
Authorized Official - Middle Name:
Authorized Official - Last Name:CLAPP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-265-3506
Mailing Address - Street 1:62 W KINGFIELD RD APT 6
Mailing Address - Street 2:
Mailing Address - City:KINGFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04947-4269
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:62 W KINGFIELD RD APT 6
Practice Address - Street 2:
Practice Address - City:KINGFIELD
Practice Address - State:ME
Practice Address - Zip Code:04947-4269
Practice Address - Country:US
Practice Address - Phone:207-265-3506
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care