Provider Demographics
NPI:1104060672
Name:WALDO COUNTY CHILD DEVELOPMENT SERVICE
Entity type:Organization
Organization Name:WALDO COUNTY CHILD DEVELOPMENT SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DEWEY
Authorized Official - Last Name:METEER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-338-1177
Mailing Address - Street 1:139 NORTHPORT AVENUE
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915
Mailing Address - Country:US
Mailing Address - Phone:207-338-1177
Mailing Address - Fax:207-338-9978
Practice Address - Street 1:139 NORTHPORT AVENUE
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915
Practice Address - Country:US
Practice Address - Phone:207-338-1177
Practice Address - Fax:207-338-9978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty