Individual provider · Type 1 NPI
Nichole Lavalley
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Jackson, ME
Practice location
1461 Moosehead Trl
Jackson, ME 04921
Mailing address
119 Lower Detroit Rd
Plymouth, ME 04969-3213
Other practice locations
- 119 Lower Detroit Rd, Plymouth, ME 04969-3213 · (207) 257-2131
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | ALLS 2297 (ME) |
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
About NPI 1821138017
Nichole Lavalley's National Provider Identifier is 1821138017, issued on Feb 7, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Jackson, ME. The record was last updated on Oct 30, 2019.