Organization · Type 2 NPI
Bonnie Rae Condon
Mental Illness Community Based Residential Treatment Facility · Portage Lake, ME
NPI number
1629218409
Active
Practice location
3101 Portage Rd
Portage Lake, ME 04768-3111
Fax (207) 435-6949
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
About NPI 1629218409
Bonnie Rae Condon's National Provider Identifier is 1629218409, issued on Mar 6, 2009. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Portage Lake, ME. The record was last updated on Mar 6, 2009.