Provider Demographics
NPI:1891258901
Name:CROWE'S RESIDENTIAL CARE
Entity Type:Organization
Organization Name:CROWE'S RESIDENTIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:CROWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-242-2295
Mailing Address - Street 1:604 LEIGHTON RD
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-7808
Mailing Address - Country:US
Mailing Address - Phone:207-242-2295
Mailing Address - Fax:207-495-9140
Practice Address - Street 1:604 LEIGHTON RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-7808
Practice Address - Country:US
Practice Address - Phone:207-623-5355
Practice Address - Fax:207-623-5355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-08
Last Update Date:2019-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities