Healthcare Provider Details

I. General information

NPI: 1245232347
Provider Name (Legal Business Name): ANDROSCOGGIN HOME HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2005
Last Update Date: 07/10/2025
Certification Date: 07/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 STRAWBERRY AVE
LEWISTON ME
04240-5941
US

IV. Provider business mailing address

15 STRAWBERRY AVE
LEWISTON ME
04240-5941
US

V. Phone/Fax

Practice location:
  • Phone: 207-777-7740
  • Fax: 207-777-7748
Mailing address:
  • Phone: 207-777-7740
  • Fax: 207-777-7748

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KENNETH JOSEPH ALBERT
Title or Position: PRESIDENT/CEO
Credential: RN
Phone: 207-795-9442