Provider Demographics
NPI:1033722236
Name:MAINE SHARED LIVING
Entity Type:Organization
Organization Name:MAINE SHARED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LECLAIR-VOISINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-320-8730
Mailing Address - Street 1:250 CENTER ST PMB 368
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210
Mailing Address - Country:US
Mailing Address - Phone:207-320-8730
Mailing Address - Fax:
Practice Address - Street 1:715 UPPER ST
Practice Address - Street 2:
Practice Address - City:TURNER
Practice Address - State:ME
Practice Address - Zip Code:04282-3808
Practice Address - Country:US
Practice Address - Phone:207-320-8730
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities