Provider Demographics
NPI:1710767009
Name:MIDCOAST CASE MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:MIDCOAST CASE MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:N
Authorized Official - Last Name:WILMOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-542-7649
Mailing Address - Street 1:59 OLD COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-4007
Mailing Address - Country:US
Mailing Address - Phone:207-542-7649
Mailing Address - Fax:207-593-1091
Practice Address - Street 1:59 OLD COUNTY RD UNIT A
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:ME
Practice Address - Zip Code:04856-4007
Practice Address - Country:US
Practice Address - Phone:207-593-1099
Practice Address - Fax:207-593-1091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty