Provider Demographics
NPI:1740888114
Name:MAINE COMMUNITY HOMECARE
Entity type:Organization
Organization Name:MAINE COMMUNITY HOMECARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DIDIER
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKIZIMANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-838-3467
Mailing Address - Street 1:PO BOX 1112
Mailing Address - Street 2:
Mailing Address - City:WESTBROOK
Mailing Address - State:ME
Mailing Address - Zip Code:04098-1112
Mailing Address - Country:US
Mailing Address - Phone:207-838-3467
Mailing Address - Fax:
Practice Address - Street 1:33 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:WESTBROOK
Practice Address - State:ME
Practice Address - Zip Code:04092-4003
Practice Address - Country:US
Practice Address - Phone:207-838-3467
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care