Provider Demographics
NPI:1225672074
Name:MAINE CONNECT CARE LLC
Entity Type:Organization
Organization Name:MAINE CONNECT CARE LLC
Other - Org Name:MAINE CONNECT CARE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AHDAF
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHAMKHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-329-6860
Mailing Address - Street 1:36 GUINEA RD
Mailing Address - Street 2:
Mailing Address - City:BIDDEFORD
Mailing Address - State:ME
Mailing Address - Zip Code:04005-9101
Mailing Address - Country:US
Mailing Address - Phone:207-329-6860
Mailing Address - Fax:
Practice Address - Street 1:36 GUINEA RD
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9101
Practice Address - Country:US
Practice Address - Phone:207-329-6860
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2020-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health