Provider Demographics
NPI:1699918839
Name:BOWLER FOSTER HOME
Entity type:Organization
Organization Name:BOWLER FOSTER HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BOBBIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BOWLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-377-4472
Mailing Address - Street 1:PO BOX 36
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04259-0036
Mailing Address - Country:US
Mailing Address - Phone:207-377-4472
Mailing Address - Fax:
Practice Address - Street 1:7 BESSIE RD
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:ME
Practice Address - Zip Code:04364-4226
Practice Address - Country:US
Practice Address - Phone:207-377-4472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities