Healthcare Provider Details

I. General information

NPI: 1720212335
Provider Name (Legal Business Name): MAINE-LY ELDER CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 CENTER ST.
OAKLAND ME
04963
US

IV. Provider business mailing address

28 CENTER ST.
OAKLAND ME
04963
US

V. Phone/Fax

Practice location:
  • Phone: 207-465-3249
  • Fax: 207-465-7864
Mailing address:
  • Phone: 207-465-3249
  • Fax: 207-465-7864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
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 Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. DENISE ROGERS STEVENS
Title or Position: CEO
Credential: R.N.
Phone: 207-465-3249