Provider Demographics
NPI:1275682882
Name:THE MAINE CHILDREN'S HOME FOR LITTLE WANDERERS
Entity Type:Organization
Organization Name:THE MAINE CHILDREN'S HOME FOR LITTLE WANDERERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:H
Authorized Official - Last Name:ABRAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-873-4253
Mailing Address - Street 1:93 SILVER ST
Mailing Address - Street 2:
Mailing Address - City:WATERVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04901-5923
Mailing Address - Country:US
Mailing Address - Phone:207-873-4253
Mailing Address - Fax:207-872-7548
Practice Address - Street 1:93 SILVER ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5923
Practice Address - Country:US
Practice Address - Phone:207-873-4253
Practice Address - Fax:207-872-7548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEMM9109Medicare ID - Type Unspecified