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Nichole Lavalley
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Jackson, Maine
NPI 1821138017

Nichole Lavalley is a Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility based in Plymouth, ME. Nichole Lavalley practices in Jackson, ME. The NPI Number for Nichole Lavalley is 1821138017 and holds a License No. ALLS 2297 (Maine).

The current practice location address for Nichole Lavalley is 1461 Moosehead Trl, Jackson, ME and can be reached out via phone at 207-907-2631.

Location: 1461 Moosehead Trl, Jackson, ME, 04969-3213
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1821138017
Provider Name
Nichole Lavalley
Credential
Provider Entity Type
Individual
Gender
Female
Address
1461 Moosehead Trl, Jackson, ME, 04969-3213
Phone Number
207-907-2631
Fax Number
Provider Enumeration Date
02/07/2007
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
1461 Moosehead Trl
City
Jackson
State
Maine
Zip
04921
Phone Number
207-907-2631
Fax Number
person
Provider Business Mailing Address Details
Address
1461 Moosehead Trl
City
Jackson
State
Maine
Zip
04921
Phone Number
207-907-2631
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320900000X
License No.
ALLS 2297 (Maine)
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.
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