Provider Demographics
NPI:1497422489
Name:SACOPEE VALLEY NURSING AND HOME HEALTH CARE
Entity Type:Organization
Organization Name:SACOPEE VALLEY NURSING AND HOME HEALTH CARE
Other - Org Name:SACOPEE VALLEY NURSING CARE
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:DUBOIS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-205-9363
Mailing Address - Street 1:83 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:ME
Mailing Address - Zip Code:04068-3537
Mailing Address - Country:US
Mailing Address - Phone:207-205-9363
Mailing Address - Fax:
Practice Address - Street 1:83 SUMMER ST
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:ME
Practice Address - Zip Code:04068-3537
Practice Address - Country:US
Practice Address - Phone:207-205-9363
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-26
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No251J00000XAgenciesNursing Care