Provider Demographics
NPI:1245603851
Name:STAND BY ME HOME CARE LLC
Entity Type:Organization
Organization Name:STAND BY ME HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KARENL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-761-4957
Mailing Address - Street 1:23 MASSACHUSETTS AVENUE
Mailing Address - Street 2:
Mailing Address - City:OCEAN PARK
Mailing Address - State:ME
Mailing Address - Zip Code:04063
Mailing Address - Country:US
Mailing Address - Phone:646-761-4957
Mailing Address - Fax:
Practice Address - Street 1:23 MASSACHUSETTS AVENUE
Practice Address - Street 2:
Practice Address - City:OCEAN PARK
Practice Address - State:ME
Practice Address - Zip Code:04063
Practice Address - Country:US
Practice Address - Phone:646-761-4957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-04
Last Update Date:2015-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health