Provider Demographics
NPI:1902035264
Name:FULL HOUSE, INC.
Entity Type:Organization
Organization Name:FULL HOUSE, INC.
Other - Org Name:HELPING HANDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BUSHEY
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE
Authorized Official - Phone:207-873-0011
Mailing Address - Street 1:PO BOX 93
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04903-0093
Mailing Address - Country:US
Mailing Address - Phone:207-873-0011
Mailing Address - Fax:207-877-0620
Practice Address - Street 1:32 COLLEGE AVE STE 104
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6100
Practice Address - Country:US
Practice Address - Phone:207-873-0011
Practice Address - Fax:207-877-0620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-08
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care