Provider Demographics
NPI:1356476261
Name:PERSONAL SERVICES OF AROOSTOOK
Entity Type:Organization
Organization Name:PERSONAL SERVICES OF AROOSTOOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:ALANSCEN
Authorized Official - Last Name:DUPREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-764-3766
Mailing Address - Street 1:480 MAIN ST STE 402
Mailing Address - Street 2:
Mailing Address - City:PRESQUE ISLE
Mailing Address - State:ME
Mailing Address - Zip Code:04769-2345
Mailing Address - Country:US
Mailing Address - Phone:207-764-3766
Mailing Address - Fax:207-764-3359
Practice Address - Street 1:480 MAIN STREET
Practice Address - Street 2:SUITE 402
Practice Address - City:PRESQUE ISLE
Practice Address - State:ME
Practice Address - Zip Code:04769
Practice Address - Country:US
Practice Address - Phone:207-764-3766
Practice Address - Fax:207-764-3359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
165380100OtherMAINE CARE
165380201OtherMAINE CARE
165380200OtherMAINE CARE