Provider Demographics
NPI:1043446289
Name:MY FRIEND'S PLACE - FIRST UNITED METHODIST CHURCH
Entity type:Organization
Organization Name:MY FRIEND'S PLACE - FIRST UNITED METHODIST CHURCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:I
Authorized Official - Last Name:FISTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-945-0122
Mailing Address - Street 1:703 ESSEX ST
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3509
Mailing Address - Country:US
Mailing Address - Phone:207-945-0122
Mailing Address - Fax:
Practice Address - Street 1:703 ESSEX ST
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3509
Practice Address - Country:US
Practice Address - Phone:207-945-0122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS2880385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care