Provider Demographics
NPI:1427768951
Name:DAVIS, TREVOR (PERSONAL CARE)
Entity type:Individual
Prefix:
First Name:TREVOR
Middle Name:
Last Name:DAVIS
Suffix:
Gender:M
Credentials:PERSONAL CARE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 29
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04441-0029
Mailing Address - Country:US
Mailing Address - Phone:207-280-0661
Mailing Address - Fax:
Practice Address - Street 1:451 B MOOSEHEAD LAKE ROAD
Practice Address - Street 2:
Practice Address - City:GREENVILLE MAINE
Practice Address - State:ME
Practice Address - Zip Code:04441
Practice Address - Country:US
Practice Address - Phone:207-280-0661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No251E00000XAgenciesHome Health
No374K00000XNursing Service Related ProvidersReligious Nonmedical Practitioner
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker