Healthcare Provider Details

I. General information

NPI: 1225469737
Provider Name (Legal Business Name): LEEMAN'S PERSONAL CARE AGENCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2013
Last Update Date: 12/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2228 NEW VINEYARD RD
NEW VINEYARD ME
04956-0091
US

IV. Provider business mailing address

PO BOX 91
NEW VINEYARD ME
04956-0091
US

V. Phone/Fax

Practice location:
  • Phone: 207-650-7793
  • Fax:
Mailing address:
  • Phone: 207-650-7793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number StateME
# 4
Primary TaxonomyN
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number StateME
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateME
# 6
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateME

VIII. Authorized Official

Name: LOIS LEEMAN
Title or Position: OWNER/PSS,CRMA,MHSS,LTCFL
Credential: PSS, CRMA, MHSS
Phone: 207-650-7793