| Organization Name: | PAT CHANTERELLE LLC |
| NPI Number: | 1003173972 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICIA CHANTERELLE (PRESIDENT) |
| Mailing Address: | 30 Forest Falls Dr Suite 1 Yarmouth |
| State: | ME US |
| Postal Code: | 040966983 |
| Phone Number: | 2078467711 |
| Fax Number: | 2078467711 |
| NPI Enumeration Date: | 04/17/2012 |
| NPI Last Update Date: | 07/10/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 284300000X |
| License Number: | CR601 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Hospitals |
| Taxonomy Classification: | Special Hospital |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A designation by the AHA of a hospital whose primary function of the institution is to provide diagnostic and treatment services for patients who have specified medical conditions, both surgical and nonsurgical. |