Provider Demographics
NPI:1932152279
Name:EASTERN MAINE HOMECARE
Entity Type:Organization
Organization Name:EASTERN MAINE HOMECARE
Other - Org Name:RIVER VALLEY HOMECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SOUCY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-498-2578
Mailing Address - Street 1:24 LAWRENCE DR
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:ME
Mailing Address - Zip Code:04937
Mailing Address - Country:US
Mailing Address - Phone:207-453-2499
Mailing Address - Fax:
Practice Address - Street 1:24 LAWRENCE DRIVE
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:ME
Practice Address - Zip Code:04937
Practice Address - Country:US
Practice Address - Phone:207-453-2499
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME02737251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEM23709OtherCIGNA/CARE CENTRIX PROVID
ME2598350OtherAETNA PROVIDER #
ME102170100Medicaid
ME102170100Medicaid