Healthcare Provider Details

I. General information

NPI: 1902781180
Provider Name (Legal Business Name): MAINE MOTHER AND COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2025
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 CUMBERLAND ST STE 5
BRUNSWICK ME
04011-1829
US

IV. Provider business mailing address

54 CUMBERLAND ST STE 5
BRUNSWICK ME
04011-1829
US

V. Phone/Fax

Practice location:
  • Phone: 207-406-4218
  • Fax:
Mailing address:
  • Phone: 207-406-4218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICOLE HART
Title or Position: CO-OWNER
Credential: IBCLC
Phone: 207-542-0332