Provider Demographics
NPI:1962637009
Name:REBECCA TOUPIN
Entity Type:Organization
Organization Name:REBECCA TOUPIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:R
Authorized Official - Last Name:TOUPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-532-4183
Mailing Address - Street 1:7 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-2107
Mailing Address - Country:US
Mailing Address - Phone:207-532-4183
Mailing Address - Fax:207-532-4183
Practice Address - Street 1:7 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-2107
Practice Address - Country:US
Practice Address - Phone:207-532-4183
Practice Address - Fax:207-532-4183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME411890000Medicaid