Provider Demographics
NPI:1649412164
Name:EMPLOYMENT SPECIALISTS OF MAINE, INC.
Entity type:Organization
Organization Name:EMPLOYMENT SPECIALISTS OF MAINE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ULMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-622-5946
Mailing Address - Street 1:776 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8307
Mailing Address - Country:US
Mailing Address - Phone:207-622-5946
Mailing Address - Fax:207-622-4667
Practice Address - Street 1:776 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8307
Practice Address - Country:US
Practice Address - Phone:207-622-5946
Practice Address - Fax:207-622-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-30
Last Update Date:2009-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME123900300Medicaid
ME123900302Medicaid